Widget Image

 

I receive in Florence, Milan and Reggio Calabria

 

Florence
Uran Health Clinic
Via Sandro Pertini, 42
50127 - Firenze (FI)
Phone: 331 234 9171
Milan
Blumar Medical Center
Viale Vittorio Veneto, 14
20124 - Milan (MI)
Phone: 02 2941 2460
Reggio Calabria
Studio Medico Cassone
Via Nazionale, 426
89018 - Villa S. Giovanni (RC)
Phone: 331 234 9171

Benign prostatic hypertrophy (BPH)

PATHOLOGIES

Benign prostatic hypertrophy (BPH)

THE PROSTATE

The prostate is a gland present only in the male, weighing about 20 grams, located in the pelvis below the bladder; in the center it is crossed by the first portion of the urethra, a small duct that carries urine from the bladder to the outside during urination. The function of the prostate is to produce most of the seminal fluid, which is poured into the prostatic urethra during ejaculation. It is therefore an essential organ for male reproductive function. Conversely, the prostate does not participate in the function of penile erection and orgasm. This gland can undergo various pathologies, the most frequent of which are inflammation (prostatitis), enlargement also called benign prostatic hypertrophy (BPH) and prostate cancer.

BENIGN PROSTATIC HYPERTROPHY (BPH)

Benign prostatic hypertrophy is a rather common disease and affects people over the age of 40-50. It is an enlargement (adenoma) of the central part of the gland, which causes a change in the caliber of the prostatic urethra which crosses it with a consequent obstacle to the outflow of urine to the moment of urination. This is the reason for the urinary symptoms experienced by patients with BPH. In fact, the most frequent symptoms include difficulty urinating, hypovalidity of the urinary stream, urinary urgency and the need to urinate frequently, even during the night. The disease is progressive, in the sense that over time a progressive enlargement of the gland corresponds to a worsening of the symptoms. However, there is not always a close correlation between prostate size and symptoms, in the sense that there are also asymptomatic subjects with a very large prostate, as well as subjects with a small prostate who complain of very obvious symptoms. In the initial phase of the disease, the bladder is able to compensate at least partially for the obstruction because, being the bladder wall made up of several muscle layers, it can contract with greater force, allowing urine to overcome the obstacle. Over time, however, the bladder tends to wear out and begins to fail its task, causing difficulty in urinating and the possible stagnation of urine in the bladder which can cause the onset of urinary tract infections, due to the presence of bacteria in the bladder. bladder. If this condition is not resolved, functional damage to the bladder may result which, in extreme cases, may lead to the need to resort to definitive bladder catheterization.

DIAGNOSTIC INVESTIGATION

For the diagnosis of this pathology we have several tools available: • Rectal examination: allows you to palpate the prostate directly and appreciate its size and consistency (a hard or uneven prostate can suspect a tumor of the same ). • PSA (prostate specific antigen) dosage: PSA is a protein produced by the prostate necessary for correct function of the seminal fluid. It is measured in the blood after a normal blood sample. Usually in patients with BPH its value is slightly increased. However, it should be noted that when the PSA is increased, it is also essential to exclude the presence of prostate cancer. • Trans-rectal ultrasound: a probe is inserted into the rectum and thanks to this it is possible to directly visualize the prostate and the adenoma, and define I specify the dimensions and the possible presence of suspicious areas for tumors or in any case pathological. • Uroflowmetry and Urodynamic Testing: allow to evaluate the behavior of the urinary tract during urination. They give information about the extent and speed of the urine flow, the function of the bladder, and other parameters useful for quantifying the patient’s symptoms. At the end of these tests, it is also possible to evaluate the post-voiding residue, i.e. the amount of urine that remains in the bladder at the end of urination, which in healthy subjects is null, while in patients with BPH or functional damage to the bladder muscle it can reach even very high values. • Urine test: allows you to highlight both any ongoing urinary tract infections and the presence of blood which can be an indicator of other pathologies.< /span>

THERAPY

The goals of therapy for benign prostatic hypertrophy are the resolution of urinary symptoms, the prevention of bladder and kidney damage and, overall, the improvement of the patient’s quality of life. When the disease is in the initial stage with irritative symptoms and without a clear urinary obstruction, medical therapy can be used, using drugs that act on the urinary disorders described above. Three categories of medicines are available today:1. Plant extracts such as Serenoa Repens (Permixon , Profluss); 2. Alytic drugs, such as Alfuzosin (Alfuzosin DOC, Mittoval or Xatral), Silodosin (Urorec or Silodix); Tamsulosin (Omnic or Pradif) 3. 5alpha-reductase inhibitors, such as Dutasteride (Avodart) and Finasteride (Proscar, Prostide).On the other hand, when the disease is characterized by a clear urinary obstruction, surgery is indicated, in order to both resolve the patient’s complaints and, more importantly, protect bladder and kidney function. The operation consists in the removal of the adenoma, i.e. that part of the prostate that is responsible for the obstruction.To do this, various surgical techniques can be used.

• Transurethral resection of the prostate (TURP): an instrument is inserted into the urethra, it goes up to the prostate and the central part of the gland, responsible for the obstruction, is resected using a diathermic loop. This technique is usually used for prostates weighing up to 80g. She is burdened by moderate bleeding and requires the maintenance of a bladder catheter for 3-4 days.
• Holmium laser enucleation of prostate adenoma (HoLEP): it is a method similar to the previous one, with the important difference that the adenoma is not resected, but is detached from the prostatic capsule using a laser. This technique is used today for prostates weighing up to 300g and is associated with numerous advantages: reduced bleeding, maintenance of the bladder catheter for 24-72 hours and reduced hospital stay.

• Trans-vesical adenomectomy (ATV): through a cut below the navel, the prostate is reached, the adenoma is detached from the prostatic capsule and removed. This is a traditional surgical technique that is typically used by surgeons not expert in the Holmium laser method; currently this approach is reserved exclusively for very large prostates. It is necessary to keep the bladder catheter on for 4-6 days during which the patient is often bothered by the pain associated with the abdominal incision and the bladder catheter itself. It is also associated with the need for postoperative blood transfusions in about 10% of cases. Following the introduction of the Holmium laser technique, this technique has been largely abandoned.

DO YOU BELIEVE YOU HAVE A PROBLEM?

Ask a question
to Dr. Cocci

You will receive a reply from Dr. Cocci privately to your e-mail address, and you will be able to evaluate without obligation whether to book the specialist visit.





    Book a visit or consultation

    I see patients at the facilities in Milan, Florence, and Reggio Calabria.

    Book your first visit or specialist consultation at the location nearest you.

    Patients residing abroad can also request an initial remote consultation via video conferencing.

    Florence | Uran Health Clinic

    Via Sandro Pertini, 4
    50127 – Florence (FI)
    Phone: +39 331 234 9171

    Milan | Blumar Medica

    Viale Vittorio Veneto, 14
    20124 – Milan (MI)
    Telefono: +39 02 2941 2460

    Reggio C. | Studio Medico Cassone

    Via Nazionale 426
    89018 – Villa San Giovanni (RC)
    Phone: +39 331 234 9171

    Video consultation

    Dr. Andrea Cocci

    urologist and andrologist

    The decision to dedicate my professional life to urology, and in particular to andrological and reconstructive surgery, stems from a deep passion for anatomy, the art of surgery, and, more generally, the diagnostic and therapeutic process that leads to the patient’s recovery. Oncological pathology, infertility, erectile dysfunction, penile diseases or simply prostate disorders irreparably afflict not only the individual but also the couple.

    Dr. Andrea Cocci

    Urologist and andrologist

    I receive in: Florence, Milan, Reggio Calabria

    I have full conviction that listening to the patient, carping about his or her needs, and assessing his or her expectations is the only way to establish a therapeutic program of success and satisfaction for both physician and patient.

    Linkedin Youtube Facebook Instagram
    “… I am fully convinced that listening to the patient, understanding their needs, and assessing their expectations is the only way to establish a successful and satisfying treatment program for both the doctor and the patient.”

    Contatti

    I receive patients in Florence, Milan, and Reggio Calabria.
    Whatsapp
    Info and reservations: +39 331 234 9171
    Florence
    Uran Health Clinic
    Via Sandro Pertini, 4
    50127 – Florence (FI)
    Phone: +39 3312349171
    Milan
    Blumar Medica
    Viale Vittorio Veneto, 14
    20124 – Milan (MI)
    Phone: +39 02 29412460
    Reggio Calabria
    Cassone Medical Practice
    Via Nazionale 426
    89018 – Villa San Giovanni (RC)
    Phone: +39 3312349171

    Andrologia

    Erectile Dysfunction
    Curved Penis
    Phimosis / Short Frenulum
    Hypospadias
    Sexually transmitted diseases
    Premature ejaculation
    Infertility
    Hypogonadism

    Urologia

    Urinary tract infections
    Incontinence
    Prostatitis
    Prostatic Hypospadias
    Prostate Cancer
    Testicular Cancer
    Bladder Cancer

    © Andrea Cocci 2022 | Privacy policy | Cookie policy | Credits