Database of diseases - Sexual health

 
In menin old age -prostate, also known as the prostate - is growing, causing many ailments to men. Its proliferation causes the narrowing of the urethra, a tubular duct that is urinated from the bladder.







Prostate hyperplasia causes discomfort

They are associated with urination: - pollakiuria, unpleasant pressure, narrow, lazy stream, and finally the total impossibility of urinating. These ailments significantly reduce the quality of life, are the cause of constant fatigue and irritability. An untreated disease can be life-threatening.


Prostatic hyperplasia - symptoms and examination

In the early stages of the disease, different types of medications are used that, without removing the adenoma, reduce the symptoms and improve the quality of life. The pharmacological treatment of LRS is aimed at eliminating or alleviating lower urinary tract ailments and eliminating the obstruction of the bladder outlet, if its severity indicates such a need.


Currently, medicine has the following methods of treatment:

-pharmacological treatment,

- few invasive treatment methods,

-Surgical treatment.



Pharmacological treatment is used in patients with moderate or moderate symptoms, but with conditions:

- there are no absolute indications for surgical treatment,

- do not consent to surgical treatment

- due to high operational risk, you can not undergo surgical treatment

We have 4 groups of medicines to treat mild growth:

alpha-blockers,

- 5-alpha reductase inhibitors,

-polyelinohydrolides,

plant preparations.

 
        

ALPHA-ADRENOLYTIC

Alpha-blockers are the group most commonly used by urologists.

They work blocking the alpha-1 adrenergic receptors. These receptors are found in large quantities around the bladder base, the bladder neck, the prostatic coil and in the prostate muscle.

The consequence of stimulation of these receptors is the contraction of the smooth muscle organs present in the above mentioned organs. Blocking of receptors leads in turn to a reduction in the tension of the appropriate muscle fibers responsible for the size of the tubular "grip" blocking the flow of urine from the bladder. The prostate is dominated by the alpha 1A receptor, the number of remaining is much smaller. (Alfa-2 receptors are also found in the body alongside the alpha-1 adrenergic receptors, particularly in the cardiovascular system.)



Prostate and alpha receptors

In the treatment of LRS, adrenolytics that only act on alpha-1 receptors, called uroselective, are used. The above criteria are met by: doxazosin, alfuzosin, terazosin and tamsulosin. The whole group is characterized by high effectiveness, manifested by a significant alleviation or even elimination of complaints from the lower urinary tract and rapid achievement of therapeutic effects and their longevity.

Side effects (seen in 5-20% of patients) include:

drop in blood pressure, dizziness, tachycardia, retrograde ejaculation or decreased volume of ejaculate.
 

5-ALPHA REDUCTURE INHIBITORS

Inhitors of 5-alpha reductase affect the transformation of sex hormones.

The effect of androgens - testosterone and its active form - dihydrotestosterone (DHT) on the development of benign prostate hyperplasia is undisputed. Therefore, the weakening of their effect on the prostate is readily used by inhibiting the conversion of testosterone into the active form - dihydrotestosterone (DHT) with the help of other 5-alpha reductase inhibitors. The only representative of this group is finasteride.

The effect of finasteride is the decrease in DHT levels.

It is important and beneficial that this drug does not have a significant impact on testosterone levels, which allows to avoid disruptive side effects. The use of finasteride reduces symptoms and improves urinary fiction. The therapeutic effect of the drug is achieved after several weeks of treatment.
 

POLYENER MAKROLIDES

Polyene macrolides lower the concentration of estrogens in the blood eliminating one of the factors of prostatic hyperplasia.

The male kernels produce small amounts of estrogen. However, in total these female hormones are much more. Approx. 80% of estrogens present in the man's blood serum comes from the transformation of testosterone and androstenedione hormones - in the presence of enzymes (referred to as aromatersases) - in estrogens.

The substance used in the treatment of benign prostatic hyperplasia is mepartrycin, which inactivates estrogens by binding to the intestines.

The beneficial effect of mepartrycin on the disappearance of symptoms felt as subjective LRS and an improvement in urethral urinary flow was observed.

 

PLANT PREPARATIONS

Plant preparations owe their popularity mainly to minimal side effects.

They alleviate the symptoms of LR during the early stages of the disease, but the effect of many of them is comparable with placebo.

For the production of plant medicines, extracts from various plants are used:

♦ African plum bark (Tadenan, Poldanen),

♦ pumpkin seeds (Peposterol),

♦ nettle root (Prostaherb, Prostatonin),

♦ corn sprouts (Prosterol),

♦ dwarf fruit (fruit of the sabal palm - Prostamol Uno, Permixon).


The active substances in these preparations are:

phytosterols, tannins, flavonoids, saponins, fatty acids and essential oils. Their therapeutic effect is explained by anti-inflammatory, anti-swelling and antibacterial effects. In addition, Prostamol Uno and Permixon are presumed to block an enzyme called 5-alpha reductase, and Tadenan reduces aromatase activity and improves bladder detrusor function.


Particularly preferably, they restrict the growth of plant prostate phytosterols

These substances regenerate the epithelial cells of the prostate gland, reduce swelling and hyperplasia of the stroma. Thanks to this, they reduce the prostate hypertrophy, which relaxes the "compressed rim" on the urethra. The tension of the urethra and bladder muscles also decreases. These properties improve the strength and volume of the urine output.

Plant phytosterols inhibit prostatic hyperplasia
 
Ed. Edward Ozga Michalski, MA