Kev kho mob rau benign prostatic hyperplasia
Cov tsos mob me me, ruaj khov tsuas yog tuaj yeem soj ntsuam hauv tsev kho mob thaum lub sijhawm kuaj mob ib xyoos ib zaug.
pharmaceuticals
Alphabloquants. Alpha blockers pab ua kom cov leeg nqaij du hauv cov prostate thiab lub caj pas zais zis. Qhov no txhim kho lub zais zis nrog txhua qhov tso zis, txo qis kom nquag tso zis. Tsev neeg alpha blocker suav nrog tamsulosin (Flomax®), terazosin (Hytrin®), doxazosin (Cardura®) thiab alfuzosin (Xatral®). Lawv qib kev ua tau zoo yog piv. Cov txiaj ntsig tau hnov sai, tom qab 1 lossis 2 hnub ntawm kev kho mob. Qee cov tshuaj no tau xub siv los kho ntshav siab, tab sis tamsulosin thiab alfuzosin tshwj xeeb kho benign prostatic hyperplasia.
Qee yam tshuaj no tuaj yeem ua rau kiv taub hau, qaug zog, lossis ntshav siab. Cov ntshav qis kuj tuaj yeem tshwm sim yog tias cov tshuaj alpha blockers tau siv tib lub sijhawm ua tshuaj tsis haum (sildenafil, vardenafil, lossis tadalafil). Tham nrog nws tus kws kho mob.
5-alpha-reductase inhibitors. Cov tshuaj no, uas yog finasteride (Proscar®) thiab dutasteride (Avodart®) yog ib feem, txo qis kev tsim cov dihydrotestosterone. 5-alpha-reductase yog ib yam tshuaj uas hloov pauv testosterone rau hauv nws cov metabolite nquag, dihydrotestosterone. Qhov ua tau zoo tshaj plaws ntawm kev kho mob tau pom 3 txog 6 lub hlis tom qab pib siv tshuaj. Muaj qhov txo qis hauv qhov ntim ntawm prostate li ntawm 25 txog 30%. Cov tshuaj no ua rau erectile kawg li ntawm 4% ntawm cov txiv neej uas coj lawv. Nce ntxiv, lawv tau siv ua ke nrog alpha blockers.
Sau ntawv. Finasteride txo qis kev pheej hmoo ntawm kev txhim kho mob qog noj ntshav prostate, raws li kev tshawb fawb loj tau ua hauv 2003 (Kev Tiv Thaiv Kev Tiv Thaiv Kab Mob Prostate)7. Paradoxically, hauv txoj kev tshawb fawb no, cov kws tshawb fawb tau sau tseg kev koom tes ntawm kev noj cov tshuaj finasteride thiab kev tshawb pom me ntsis ntawm qhov mob hnyav ntawm qog noj ntshav prostate. Qhov kev xav tias finasteride ua rau muaj kev pheej hmoo mob qog noj ntshav qog noj ntshav loj tau txij li tau rov hais dua. Tam sim no nws tau paub tias kev kuaj pom daim ntawv mob qog noj ntshav no tau txhawb nqa los ntawm qhov tseeb tias qhov loj ntawm prostate tau txo qis. Ib qho prostate me me pab txheeb xyuas cov qog nqaij hlav.
Tseem ceeb heev. Nco ntsoov tias tus kws kho mob uas txhais lus kuaj ntshav prostate antigen (PSA) paub txog kev kho nrog finasteride, uas txo qis qib PSA. Txhawm rau kom paub ntau ntxiv txog qhov kev tshuaj ntsuam xyuas no, saib peb daim ntawv pov thawj mob qog noj ntshav prostate.
Kev kho ua ke. Kev kho mob suav nrog noj alpha blocker thiab 5-alpha-reductase inhibitor tib lub sijhawm. Kev sib xyaw ntawm 2 hom tshuaj yuav ua tau zoo dua ib qho ntawm lawv hauv kev ua kom qeeb ntawm tus kab mob thiab txhim kho nws cov tsos mob.
Kev phais
Yog tias kev kho tshuaj tsis ua rau muaj kev txhim kho, kev phais yuav raug txiav txim siab. Txij hnub nyoog 60 xyoo, 10 txog 30% ntawm cov neeg mob siv kho mob phais kom txo tau cov tsos mob ntawm benign prostatic hyperplasia. Kev phais yuav tsim nyog thaum muaj teeb meem.
Transurethral resection ntawm prostate lossis TURP. Qhov no yog kev cuam tshuam feem ntau tau ua, vim nws ua tau zoo. Ib qho cuab yeej siv endoscopic tau qhia los ntawm lub qhov zis mus rau lub zais zis. Nws tso cai rau kev tshem tawm ntawm qhov chaw hyperplasied ntawm prostate. Qhov haujlwm no tseem tuaj yeem ua tiav siv lub laser.
Yuav luag 80% ntawm cov txiv neej uas tau ua cov txheej txheem no ces muaj retrograde ejaculation : es tsis txhob ejaculated, cov phev raug coj mus rau lub zais zis. Erectile zog tseem nyob li qub.
Sau ntawv. Dhau li ntawm TURP, lwm yam, txoj hauv kev tsawg dua tuaj yeem rhuav tshem cov ntaub so ntswg prostate: microwaves (TUMT), radiofrequencies (TUNA) lossis ultrasound. Kev xaiv txoj hauv kev nyob ntawm lwm yam ntawm cov ntaub so ntswg uas yuav raug tshem tawm. Qee lub sij hawm cov hlab nyias tau muab tso rau hauv lub qhov zis kom lub qhov quav qhib. Kev ua haujlwm yog ua nyob rau hauv cheeb tsam lossis tshuaj loog dav, thiab kav ntev txog 90 feeb. Los ntawm 10% txog 15% ntawm cov neeg mob ua haujlwm yuav tau phais thib ob hauv 10 xyoo ntawm kev ua haujlwm.
Transurethral incision ntawm prostate lossis ITUP. Qhov kev qhia ua haujlwm rau kev mob siab me me yog ua kom lub qhov zis nthuav dav los ntawm kev ua qhov txhab me me hauv lub caj dab ntawm lub zais zis, tsis txhob txo qhov loj ntawm prostate. Txoj haujlwm no txhim kho tso zis. Nws nqa me ntsis kev pheej hmoo ntawm teeb meem. Nws qhov ua tau zoo mus sij hawm ntev tseem yuav raug pov thawj.
Qhib phais. Thaum cov qog nqaij hlav loj (80 txog 100 g) lossis muaj teeb meem xav tau (lub sijhawm rov ua kom cov zis tso zis, lub raum puas, thiab lwm yam), qhib kev phais yuav qhia tau. Qhov kev phais mob ib txwm tau ua nyob rau hauv tshuaj loog thiab cuam tshuam nrog kev phais hauv plab qis kom tshem tawm ib feem ntawm cov qog nqaij hlav hauv lub cev. Cov txheej txheem no tuaj yeem ua rau rov qab ejaculation, zoo li yog kis transurethral resection. Lwm qhov tshwm sim tshwm sim ntawm kev ua haujlwm yog tso zis tso zis.