Zvinyoro, zviratidzo zvakagadzikana zvinogona kungoongororwa nekliniki panguva yekuongororwa kwechiremba gore negore.

Pharmaceuticals

Alpha quants. Alpha blockers anobatsira kuzorodza tsandanyama fiber mu prostate uye dundira mutsipa. Izvi zvinonatsiridza kubuda kwedundira nekuweti kwega kwega, zvichideredza kugara uchishuvira kuita weti. Mhuri yealpha blocker inosanganisira tamsulosin (Flomax®), terazosin (Hytrin®), doxazosin (Cardura®) uye alfuzosin (Xatral®). Chiyero chavo chekubudirira chinofananidzwa. Izvo zvinobatsira zvinonzwika nekukurumidza, mushure me1 kana 2 mazuva ekurapwa. Mimwe yemishonga iyi yakatanga kushandiswa kurapa hypertension, asi tamsulosin uye alfuzosin zvinonyanya kurapa benign prostatic hyperplasia.

Mimwe yemishonga iyi inogona kukonzera dzungu, kuneta, kana kuderera kweBP. Kuderera kweropa kunogonawo kuitika kana alpha blockers inoshandiswa panguva imwe chete se erectile dysfunction zvinodhaka (sildenafil, vardenafil, kana tadalafil). Kurukura nachiremba wake.

5-alpha-reductase inhibitors. Aya marudzi emishonga, iyo finasteride (Proscar®) uye dutasteride (Avodart®) chikamu, inoderedza kugadzirwa kwe dihydrotestosterone. 5-alpha-reductase ihomoni inoshandura testosterone kuva yayo inoshanda metabolite, dihydrotestosterone. Kubudirira kwakanyanya kwekurapa kunoonekwa 3 kusvika 6 mwedzi mushure mekutanga kwemishonga. Pane kuderera kwehuwandu hwe prostate inenge 25 kusvika ku30%. Mishonga iyi inokonzera kusashanda zvakanaka kwe erectile muzvikamu zvina kubva muzana zvevarume vanoitora. Kuwedzera, ivo vanoshandiswa pamwe chete nealpha blockers.

Notes. Finasteride inoderedza zvakanyanya njodzi yekuva nekenza yeprostate, maererano neongororo huru yakaitwa muna 2003 (iyo Prostate Cancer Prevention Trial)⁷. Sezvineiwo, muchidzidzo ichi, vaongorori vakacherekedza mubatanidzwa pakati pekutora finasteride uye nekuona zvishoma kazhinji kwerudzi rwakakomba rwegomarara reprostate. Iyo fungidziro yekuti finasteride inowedzera njodzi yegomarara reprostate yakakomba kubva ipapo yakarambwa. Izvozvi zvave kuzivikanwa kuti kuonekwa kwemhando yegomarara iri kwakafambiswa nenyaya yekuti saizi yeprostate yaive yadzikira. Prostate diki inobatsira kuona mamota.

Kunokosha. Iva nechokwadi chekuti chiremba anoturikira prostate antigen kuongororwa ropa (PSA) inoziva kurapwa nefinasteride, iyo inoderedza mazinga ePSA. Kuti uzive zvakawanda nezve ongororo iyi, ona peji redu reProstate Cancer.

Combined therapy. Kurapa kunosanganisira kutora alpha blocker uye 5-alpha-reductase inhibitor panguva imwe chete. Iko kusanganiswa kwemhando mbiri dzemishonga inenge yakanyatsoshanda kupfuura imwe yadzo mukuderedza kufambira mberi kwechirwere uye mukuvandudza zviratidzo zvayo.

Surgeries

Kana kurapwa kwezvinodhaka kusingaunzi kuvandudzwa, kurapwa kwekuvhiya kunogona kufungwa. Kubva pazera remakore makumi matanhatu, gumi kusvika makumi matatu muzana yevarwere vanoshandisa kurapwa kwekuvhiya kuti vabvise zviratidzo zvebenign prostatic hyperplasia. Kuvhiya kungave kuri madikanwa muchiitiko chezvinetso.

Transurethral resection yeprostate kana TURP. Uku ndiko kupindira kunowanzoitwa, nekuda kwekushanda kwayo kwakanaka. An endoscopic chiridzwa chinounzwa kuburikidza neurethra kune dundira. Inobvumira kupora kwe hyperplasied zvikamu zve prostate. Kuvhiya uku kunogona zvakare kuitwa uchishandisa laser.

Vanoda kusvika 80% yevarume vanoitwa chirongwa ichi vanozove ne kudzosera ejaculation : pane kubuditswa, urume hunonangidzirwa mudundira. Erectile mabasa anoramba ari akajairika.

Notes. Kunze kweTURP, zvimwe, nzira shoma dzinopinda dzinogona kuparadza yakawandisa prostate tishu: microwaves (TUMT), radiofrequencies (TUNA) kana ultrasound. Sarudzo yenzira inotsamira pakati pezvimwe zvinhu pahuwandu hwetishu inobviswa. Dzimwe nguva machubhu akatetepa anoiswa muweti kuitira kuti nzira iyi irambe yakavhurika. Kuvhiya kunoitwa pasi penharaunda kana general anesthesia, uye inotora anenge maminitsi makumi mapfumbamwe. Kubva pa90% kusvika ku10% yevarwere vakavhiyiwa vanogona kuvhiyiwa kechipiri mukati memakore gumi ekuvhiya.

Transurethral incision yeprostate kana ITUP. Kuvhiya kunoratidzwa kwepid hypertrophy ndiko kuwedzera urethra nekuita diki diki mumutsipa wedundira, pane kuderedza saizi yeprostate. Kuvhiya uku kunonatsiridza weti. Inotakura njodzi shoma yematambudziko. Kushanda kwayo kwenguva refu kunoramba kuchiratidzwa.

Open surgery. Apo prostate yakakura (80 kusvika 100 g) kana zvinetso zvinoda (nguva dzinodzokororwa dzekuchengetedza weti, kukanganisa kwetsvo, nezvimwewo), kuvhiyiwa kwakazaruka kunogona kuratidzwa. Uku kuvhiya kwakajairika kunoitwa pasi peanesthesia uye kunosanganisira kugadzira mudumbu rezasi kubvisa chikamu cheprostate gland. Iyi nzira inogona kukonzera retrograde ejaculation, sezvinoitika kune transurethral resection. Imwe mhedzisiro inogona kuitika yekuvhiya ndeye weti incontinence.