Prostatic adenoma

adenoma

Adenoma prostatic

The prostate is a “walnut–sized” gland which is part of the male reproductive system. The prostate gland surrounds the urethra and produces a milky, alkaline fluid which makes up about 60% of semen. It also contains smooth muscle fibres which help to expel semen during ejaculation.
An adenoma is a type of tumour derived from glandular tissue which is non-malignant. This means it is not cancerous. Prostatic adenoma is a benign tumour or enlargement of the prostate. It is also known as benign prostatic hyperplasia.
Even though a prostatic adenoma is benign (non-cancerous), it still causes complications and symptoms by compressing surrounding structures like the urethra.
When a man is between the ages of 30 and 40 years the prostate starts to increase in volume approximately 2,4 cm3 every year. About 8% of men between the ages of 30 and 40 have signs or symptoms of prostatic adenoma. Symptoms usually occur in men who are 50 years old and older. In men above the age of 80 years, 50%-80% will experience lower urinary tract symptoms which are as a result of prostatic adenoma. Prostatic adenoma is the most common prostate ailment in men. Virtually all men will experience symptoms of prostatic adenoma if they live long enough.
According to research studies, prostatic adenoma does not turn into prostate cancer, but the symptoms, and possibly the causes, are similar. Therefor it is advised to seek medical attention early even if the symptoms are not so severe. If a patient has prostatic adenoma it does not increase his chances of developing prostate cancer. It is possible though, to have prostatic adenoma and prostate cancer at the same time.
The exact cause of why the cells in the prostate grow and increase in number is unknown but it is possibly as a result of various hormones, impaired apoptosis and other growth factors. According to an article by the, European Association of Urology bacterial infections, dietary factors, genetic and autoimmune factors could all play a role in causing inflammation of the prostate which in turn leads to prostatic hyperplasia. The frequency of sexual intercourse and having a vasectomy does not increase the risk of developing prostatic adenoma.
 

Complications of prostatic Adenoma

     

  1. Acute Urinary Retention
  2. Patients may present with acute urinary retention. This is where the patient is unable to urinate and he develops a distended bladder which is also painful. This often follows after a man has consumed excessive amount of alcohol, has constipation or has developed a prostatic or urinary tract infection. Acute urinary retention is a medical emergency and requires a catheter to be placed in the bladder for the urine to be drained.

  3. Chronic Urinary Retention
  4. Chronic urinary retention is caused by difficulty in urinating due to obstruction of the urethra but the bladder distends over a long period of time. The patient does not feel pain in chronic urinary retention. This condition may cause pressure on the ureters and kidneys because of the distended bladder. Over a long time this damages the ureters and kidneys. This results in hydroureter, hyronephrosis and eventually renal failure which has severe consequences.

    Hyroureter is dilatation of the ureter as a result of the outflow obstruction. Hydronephrosis is dilatation and distention of the calyces in the kidney and is also a result of the outflow obstruction.

  5. Infection
  6. Benign prostatic hyperplasia makes the prostate and urinary tract more prone to infection and inflammation. Infection is usually recurrent. Infection may also present as acute urinary obstruction and is associated with fever.

    gross hematuria

    Gross hematuria

  7. Gross Hematuria
  8. About 2,5% of men with prostatic adenoma experience gross hematuria. This can vary from a reddish discoloration of urine to bloody clot formation. The reason that hematuria develops is possibly due to the increased density of small blood vessels in the prostate. If hematuria is severe it is an indication for surgery.
     

     

     
     

    bladder stones

    Bladder stones

  9. Bladder Stones
  10. If the bladder is continuously emptied unsuccessfully it can make the patient more prone to the formation of bladder stones.