The elderly subject is exposed primarily is exposed primarily to prostate adenoma which is a benign enlargement of the gland. The first sign of call is a frequent urge to urinate with emission of very low volume: it is pollakluria which is day and night. The patient has to get up several times during the night to urinate. Very gradually this pollakluria is supplemented by a delay in urination and a decrease in the force of the jet. This leads the doctor to practice a digital rectal examination: there is a firm but not hard mass, more or less bulky; transvesical pelvic ultrasound, sometimes supplemented by an ultrasound using a rectal probe, makes it possible to visualize the prostate as well as possible and assess the volume of the adenoma.
When the adenoma is large enough to lift the bladder, it may be seen indirectly by intravenous urography. The intervention is necessary when the functional discomfort is significant and before the appearance of urinary complications (retention of urine, renal failure)
Intervention by natural means (endoscopy) allows partial resection of the adenoma to be performed, but may sometimes prove to be insufficient. Transvesical adenomectomy is a more important surgical procedure but it allows the total removal of the mass. The risk of urinary incontinence following this intervention is low and the results are generally excellent.
Copyright photo : BPH.png: * Benign_Prostatic_Hyperplasia_nci-vol-7137-300.jpg: Inconnu
Bibliography : Enlargement of the Prostate: Its History, Anatomy, Aetiology, Pathology, Clinical Causes, Symptoms, Diagnosis, Prognosis, Treatment, Technique of Operations, and After-Treatment (Anglais) Relié – 26 août 2016- 508 pages