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Săptămâna urologiei la Bucureşti

October 20th, 2009, com 20 comentarii

„Patologia prostatei afectează 51% dintre bărbaţii de peste 60 de ani“

Atât de multe simpozioane şi conferinţe de presă în domeniul urologiei! Mai era nevoie de o săptămână dedicată urologiei? Asociaţia Europeană de Urologie şi Asociaţia Română de Urologie au răspuns cu „da” la această întrebare şi, drept urmare, au organizat acest eveniment dezbătând patologia urinară la bărbat. Medicii: Marcian Manu, Cristian Surcel şi Sebastian Voinea au readus în atenţia publicului şi a presei toate problemele legate de hiperplazia benignă (necanceroasă) a prostatei, cancerul de prostată şi disfuncţia erectilă.

Patologia prostatică reprezintă la nivel mondial o problemă de sănătate publică. Incidenţa bolilor prostatei afectează un procent de 80% din populaţia masculină aflată în decada opt de viaţă. La bărbatul tânăr însă predomină afecţiunile inflamatorii (prostatitele), care afectează 40% din populaţia sub 50 de ani. Din nefericire, simptomatologia în cazul afecţiunilor prostatei, ne atrag atenţia medicii, este asemănătoare atât în cazul hiperplaziei benigne a prostatei, cât şi în cazul cancerului de prostată sau prostatitei.  Manifestările sunt: urinări frecvente, efort micţional, jet urinar slab, evacuare vezicală incompletă, imposibilitatea urinării,  nevoia urinării de mai multe ori în timpul nopţii etc. Toate aceste simptome determină pacientul să se adreseze medicului, dar nici unul dintre acestea nu precizează diagnosticul corect. Un examen fizic, însoţit obligatoriu de tuşeu rectal, ecografie prostatică şi determinarea antigenului specific prostatic – PSA – sunt câteva dintre metodele de investigare pentru a stabili adevăratul diagnostic. Hiperplazia benignă a prostatei HBP (mărirea în volum a prostatei care însă nu înseamnă cancer) afectează 51% dintre bărbaţii între 60 şi 69 de ani, netratată la timp poate duce la insuficienţă renală şi în cele din urmă la deces. „Metodele de tratament ale acestei afecţiuni – a precizat conf. dr. Marcian Manu în cadrul conferinţei –  supraveghere în permanenţă în cazurile mai puţin avansate ale bolii, urmează tratamentul me­dicamentos cu medicamente din ­

grupa a-1 blocantele, dintre care cel mai eficient este Dutasterid care diminuează volumul prostatei după şase luni de tratament, iar pentru cazurile avansate de boală se recurge la metodele chirurgicale. Mai mult, el reduce cu 30% şi apariţia cancerului de prostată. Pe lângă metodele clasice de intervenţie chirurgicală mai există o serie de metode neconvenţionale precum: dilatarea prostatică, hipertermia cu microunde şi metoda cu laser denumită UROBEAM.“ Medicul Manu a insistat pe controlul urologic anual pe care trebuie să şi-l facă bărbaţii peste 55 de ani pentru a preveni complicaţiile HBP. De asemenea, prof. dr.Ionel Sinescu, şeful Clinicii de Chirurgie Urologică şi Transplant Renal din cadrul Spitalului Clinic Fundeni a ţinut să insiste pe ideea că în cazul afecţiunilor prostatei trebuie neapărat mers la medic şi nu făcută doar automedicaţie cu suplimente alimentare cărora li se face reclamă pe micul ecran. „Tratamentul cu suplimente alimentare nu se regăseşte în schemele noastre de tratament, acest gen de suplimente alimentare constituind mai mult o speculaţie. Optimismul exagerat al reclamelor descurajează adesea pacienţii să se adreseze medicului urolog, ceea ce este foarte grav.“

La rândul său, medicul Cristian Surcel a atras atenţia asupra cancerului de prostată, care este cel mai frecvent cancer la bărbaţii de peste 60 de ani, după cel pulmonar. Acest tip de cancer are o componentă genetică (riscul apariţiei sale fiind de două ori mai mare la persoanele care au avut rude de gradul I cu cancer de pros­tată şi de cinci până la unsprezece ori mai mare dacă mai multe rude din familie au avut această afecţiune), una hor­mo­nală – apare un dez­echilibru între  hormonii androgeni şi estrogeni, plus una alimentară (grăsimile animale, condimentele, fumatul, alcoolul pot determina apariţia cancerului de prostată). „Orice bărbat peste 45 de ani trebuie să beneficieze de un tuşeu rectal pentru a vedea dacă nu cumva dezvoltă o tumoră. Stabilirea naturii tumorei – malignă sau benignă – se face cel mai exact prin biopsie“, a mai precizat

dr. Cristian Surcel.

O a treia temă abordată la Săptămâna Urologiei a fost disfuncţia erectilă, care afectează atât de mult viaţa sexuală a bărbatului şi, în general, viaţa de cuplu. Statisticile arată că unul din zece bărbaţi suferă în lume de disfuncţie erectilă – DE. Contrar a ceea ce s-a crezut până acum, DE este determinată nu atât de factori psihogeni (20% din cazuri) cât de cauze organice precum: diabet, afecţiuni ale pros­tatei, hipertensiune arterială, boli de inimă etc. Factorii de risc ai apariţiei afecţiunii sunt: fumatul, obezitatea, sedentarismul, excesul de alcool ş.a.m.d. S-a dovedit că DE apare cu câţiva ani înainte de apariţia problemelor cardiace (datorită îngustării arterelor inimii) şi reprezintă un semnal de alarmă timpuriu pentru bolile de inimă. Deşi tratabilă, doar 10% dintre bărbaţi se adresează medicului şi urmează un tratament corespun­zător. Profesorul Ionel Sinescu a in­sistat asupra necesităţii consultării unui medic urolog de către pacienţii cu disfuncţie erectilă pentru a li se administra un tratament corespunzător.

Posibilităţile de tratament în cazul disfuncţiei erectile sunt: medicamentele sub formă de tablete, exerciţii ale musculaturii planşeului pelvin, tratamentul injectabil/uretral, pompa cu vacuum sau proteza peniană. Toate aceste tratamente trebuie făcute sub supravegherea urologului.


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Tuesday, October 20th, 2009 at 3:23 am, ZOOM, RSS feed

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