Izimpawu ezithambile neziqinile zingabhekwa kuphela ngokomtholampilo ngesikhathi sokuhlolwa kwezempilo kwaminyaka yonke.

izidakamizwa

Ama-Alphabloquants. Ama-Alpha blockers asiza ukukhulula imicu yemisipha ebushelelezi ku-prostate nentamo yesinye. Lokhu kuthuthukisa ukuthululwa kwesinye ngokuchama ngakunye, kunciphisa izifiso zokuchama njalo. Umndeni we-alpha blocker uhlanganisa i-tamsulosin (Flomax®), i-terazosin (Hytrin®), i-doxazosin (Cardura®) ne-alfuzosin (Xatral®). Izinga labo lokusebenza ngempumelelo liyaqhathaniswa. Izinzuzo zizwakala ngokushesha, ngemva kosuku olu-1 noma lwe-2 lokwelashwa. Eminye yale mithi ekuqaleni yayisetshenziselwa ukwelapha umfutho wegazi ophakeme, kodwa i-tamsulosin ne-alfuzosin iphatha ngokukhethekile i-benign prostatic hyperplasia.

Eminye yale mithi ingabangela isiyezi, ukukhathala, noma umfutho wegazi ophansi. Umfutho wegazi ophansi ungenzeka futhi uma i-alpha blockers isetshenziswa ngesikhathi esifanayo nezidakamizwa ze-erectile dysfunction (sildenafil, vardenafil, noma tadalafil). Xoxa nodokotela wakhe.

5-alpha-reductase inhibitors. Lezi zinhlobo zezidakamizwa, okuyi-finasteride (Proscar®) ne-dutasteride (Avodart®) ziyingxenye, zinciphisa ukukhiqizwa kwe-dihydrotestosterone. I-5-alpha-reductase iyi-hormone eguqula i-testosterone ibe yi-metabolite yayo esebenzayo, i-dihydrotestosterone. Ukusebenza okuphezulu kokwelashwa kubonwa ezinyangeni ezi-3 kuye kweziyi-6 ngemuva kokuqala komuthi. Kukhona ukuncipha kwevolumu ye-prostate cishe ngo-25 kuya ku-30%. Le mithi idala ukungasebenzi kahle kwe-erectile cishe ku-4% wamadoda ayiphuzayo. Ngokukhula, asetshenziswa ngokuhlangana nama-alpha blockers.

amanothi. I-Finasteride inciphisa kakhulu ingozi yokuba nomdlavuza wendlala yesinye, ngokusho kocwaningo olukhulu olwenziwe ngo-2003 (i-Prostate Cancer Prevention Trial)⁷. Okudidayo ukuthi, kulolu cwaningo, abacwaningi baphawule ukuhlangana phakathi kokuthatha i-finasteride nokutholwa kaningi kohlobo olubi lomdlavuza wendlala yesinye. I-hypothesis yokuthi i-finasteride inyusa ingozi yomdlavuza oyingozi we-prostate kusukela lapho iye yaphikiswa. Kuyaziwa manje ukuthi ukutholakala kwalolu hlobo lomdlavuza kube lula ngokuthi ubukhulu be-prostate behlile. I-prostate encane isiza ukubona izimila.

Okubalulekile. Qinisekisa ukuthi udokotela ohumushayo ukuhlolwa kwegazi kwe-prostate antigen (I-PSA) iyakwazi ukwelashwa nge-finasteride, eyehlisa amazinga e-PSA. Ukuthola kabanzi mayelana nalokhu kuhlolwa kokuhlolwa, bheka ikhasi lethu lamaqiniso lomdlavuza wendlala yesinye.

Ukwelapha okuhlanganisiwe. Ukwelashwa kuhlanganisa ukuthatha i-alpha blocker kanye ne-5-alpha-reductase inhibitor ngesikhathi esifanayo. Inhlanganisela yezinhlobo ezi-2 zemithi ingasebenza kangcono kunoyedwa wayo ekwehliseni ukuqhubekela phambili kwesifo nasekuthuthukiseni izimpawu zaso.

Ukuhlinzwa

Uma ukwelashwa kwezidakamizwa kungalethi ngcono, ukwelashwa kokuhlinzwa kungase kucatshangelwe. Kusukela eminyakeni engu-60, i-10 kuya ku-30% yeziguli iphendukela ekwelashweni kokuhlinzwa ukuze kukhululeke izimpawu ze-benign prostatic hyperplasia. Ukuhlinzwa kungase kudingeke uma kwenzeka kuba nezinkinga.

Ukukhishwa kwe-Transurethral kwe-prostate noma i-TURP. Lokhu ukungenelela okwenziwa kaningi, ngenxa yokusebenza kahle kwakho. Ithuluzi le-endoscopic yethulwa nge-urethra ukuya esinyeni. Ivumela ukuphulukiswa kwezingxenye ze-hyperplasied ye-prostate. Lokhu kusebenza futhi kungenziwa kusetshenziswa i-laser.

Cishe u-80% wamadoda athatha le nqubo abe a buyisela imvelo : esikhundleni sokuphuma isidoda, isidoda siqondiswe esinyeni. Imisebenzi ye-Erectile ihlala ijwayelekile.

Amanothi. Ngaphandle kwe-TURP, ezinye, izindlela ezingavamisile zingacekela phansi izicubu ze-prostate ezeqile: ama-microwaves (TUMT), ama-radiofrequencies (TUNA) noma i-ultrasound. Ukukhethwa kwendlela kuncike phakathi kwezinye izinto enanini lezicubu ezizokhishwa. Ngezinye izikhathi amashubhu azacile afakwa ku-urethra ukuze agcine lo mgudu uvulekile. Ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia yesifunda noma ejwayelekile, futhi ihlala cishe imizuzu engama-90. Kusukela ku-10% kuya ku-15% weziguli ezihlinziwe zingase zihlinzwe okwesibili phakathi neminyaka eyi-10 yokuhlinzwa.

Ukusikwa kwe-Transurethral kwe-prostate noma i-ITUP. Ukuhlinzwa okubonisiwe kwe-hypertrophy emaphakathi wukunweba i-urethra ngokwenza izimbobo ezincane entanyeni yesinye, esikhundleni sokunciphisa ubukhulu be-prostate. Lokhu kuhlinzwa kuthuthukisa ukuchama. Ithwala ingozi encane yezinkinga. Ukusebenza kwayo isikhathi eside kusazofakazelwa.

Vula ukuhlinzwa. Uma i-prostate inkulu (80 kuya ku-100 g) noma izinkinga ziyidinga (izikhathi eziphindaphindiwe zokugcinwa komchamo, ukulimala kwezinso, njll.), ukuhlinzwa okuvulekile kungase kuboniswe. Lokhu kuhlinzwa okuvamile kwenziwa ngaphansi kwe-anesthesia futhi kuhilela ukusika ngaphansi kwesisu ukuze kukhishwe ingxenye ye-prostate gland. Le nqubo ingabangela ukukhishwa kwe-retrograde ejaculation, njengoba kwenzeka ngokukhishwa kwe-transurethral. Omunye umphumela ongase ube nawo wokuhlinzwa ukungakwazi ukuzithiba komchamo.