| Abstract | Prostata, muška spolna žlijezda, počinje se razvijati oko desetog tjedna trudnoće pod utjecajem androgena. Sastoji se od tri histološke zone: periferne, središnje i prijelazne. Najčešće bolesti prostate su benigna hiperplazija prostate (BPH), karcinom prostate i prostatitis.
Benigna hiperplazija prostate najčešći je benigni tumor u muškaraca, čija prevalencija raste sukladno s dobi. Poteškoće s mokrenjem, kao glavni simptom, mogu biti opstruktivne ili iritativne. Dijagnoza se postavlja na temelju fizikalnog pregleda, analize urina te samoprocjenom simptoma korištenjem IPSS upitnika. Liječenje varira od aktivnog praćenja do medikamentozne terapije te operacije. U liječenju se za ublažavanje simptoma koriste alfa-blokatori i inhibitori 5-alfa-reduktaze, a kombinirana terapija još je učinkovitija.
Konvencionalna kirurška metoda za liječenje BPH-a uključuje transuretralnu resekciju prostate, kojom se uklanja dio prostate kako bi se olakšao protok urina. Ostale kirurške opcije uključuju transuretralnu inciziju prostate i otvorenu jednostavnu prostatektomiju, koje se koriste u slučaju značajnijeg povećanja prostate.
Minimalno invazivne metode liječenja BPH-a, kao što su laserska terapija, transuretralna elektrovaporizacija prostate, transuretralna ablacija iglom, intrauretralni stentovi te transuretralna balonska dilatacija prostate, nude učinkovite alternative tradicionalnim kirurškim zahvatima. Te metode umanjuju krvarenje, ubrzavaju oporavak te pružaju dugoročno olakšanje simptoma uz niske stope komplikacija.
Redovita kontrola bolesnika s BPH-om neophodna je u praćenju statusa pacijenta te odgovora na određenu terapiju. Kod bolesnika s blagim simptomima preporučuju se godišnje kontrole, dok se nakon uvođenja terapije pacijenti procjenjuju u intervalima od četiri do dvanaest tjedana. Pacijenti koji ne osjete poboljšanje simptoma ili imaju nepodnošljive nuspojave mogu zahtijevati daljnju procjenu i razmatranje kirurških opcija. |
| Abstract (english) | The prostate, the male sex gland, begins to develop around the tenth week of pregnancy under the influence of androgens. It consists of three histological zones: peripheral, central, and transitional. It can be affected by benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis.
Benign prostatic hyperplasia (BPH) is the most common benign tumor in men, the prevalence of which increases with age. Symptoms include difficulty urinating and may be obstructive or irritative. Diagnosis includes physical examination, urinalysis, and symptom assessment using the IPSS score. Treatment varies from watchful waiting to medication and surgery. Alpha-blockers and 5-alpha-reductase inhibitors are used to reduce symptoms, while combined therapy shows better results.
The conventional surgical method for treating BPH is transurethral resection of the prostate, which removes part of the prostate to facilitate urine flow. Alternative surgical options include transurethral incision of the prostate and open simple prostatectomy, which are used for significantly enlarged prostates.
Minimally invasive BPH treatment methods, such as laser therapy, transurethral electrovaporization of the prostate, transurethral needle ablation, intraurethral stents, and transurethral balloon dilatation of the prostate, offer effective alternatives to traditional surgical procedures. These methods reduce bleeding, speed recovery, and provide long-term symptom relief with low complication rates.
Regular follow-up of patients with BPH is essential to monitor their status and response to therapy. Annual follow-ups are recommended for patients with mild symptoms, while after starting therapy, patients are evaluated at intervals of four to twelve weeks. Patients who do not experience improvement in symptoms or have intolerable side effects may require further evaluation and consideration of surgical options. |
