Treatment of Benign Prostatic Hyperplasia (BPH) at UHS

DEPARTMENT OF UROLOGY

BENIGN PROSTATIC HYPERPLASIA

For Appointments Call: +971 6 505 8555 Or Visit: www.uhs.ae

Benign Prostatic Hyperplasia Benign Prostatic Hyperplasia Benign Prostatic Hyperplasia (BPH) is an enlarged prostate gland, which 30% of men experience symptoms by the age of 50.

What is Prostate Gland?

The prostate is a gland about a size and shape of a walnut located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.

What is the Function of the Prostate?

The prostate gland is a male reproductive organ whose main function is to secrete fluid, one of the components of semen. The muscles of the prostate gland also help propel this seminal fluid into the urethra during ejaculation.

Prostatic secretions also play a valuable role by protecting the urethra from urinary tract infections.

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Benign Prostatic Hyperplasia What is Benign Prostatic Hyperplasia?

Benign Prostatic Hyperplasia or Benign Prostatic Hypertrophy is an enlarged prostate gland. This medical condition occurs when the cells of the prostate gland begins to multiply. These additional cells cause the prostate gland to swell which squeezes the urethra and limits the ow of urine.

Cause of Benign Prostatic Hyperplasia Benign Prostatic Hyperplasia is probably a normal part of the aging process in men, caused by changes in hormonal balance and in cell growth. Half of all men have an enlarged prostate by the time they reach age 60, and by age 85, 90% of men have an enlarged prostate.

The exact cause of Benign Prostatic Hyperplasia is not entirely clear, but scientiďŹ c studies have suggested that it occurs because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth. Men produces testosterone (male hormone) and small amount of estrogen (female hormone). As men age, the amount of active testosterone in their blood decreases which leaves a higher proportion of estrogen.

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Benign Prostatic Hyperplasia Symptoms of Benign Prostatic Hyperplasia Symptoms are caused as a result of the bladder being blocked by the enlarged prostate. The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time.

Common signs and symptoms of BPH include:

Slow or Weak Urine Stream Stooping and Returning of Urine Several Times During Urination Increased Frequency of urination at Night Inability to Completely Empty the Bladder Continuous Urine Leak

Complications of Benign Prostatic Hyperplasia

Urinary Tract Infection

Sudden Urinary Retention

Bladder Stones

Complications in the kidneys and urinary bladder caused by the accumulation of large quantities of urine in the internal urinary tract.

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Benign Prostatic Hyperplasia Test and Diagnosis: To begin with, your physician will ask for your thorough medical history which includes your symptoms and physical assessment. Physical assessment your doctor will perform are the following:

01 Digital Rectal Examination

This is performed by the doctor inserting a ďŹ nger into the rectum to check the prostate for enlargement.

Examining a sample of your urine can exclude an infection or other conditions that can cause similar symptoms.

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02 Urine Test

Benign Prostatic Hyperplasia

03 Blood Test

Blood tests include creatinine and blood urea nitrogen to check for any kidney damage.

The test involves drawing blood from the arm, like the usual blood test. The blood will be sent to laboratory for analysis and often come back within several days.

PSA is a protein produced by the cells of the prostate gland. Elevated PSA levels indicate enlarged prostate.

05 Neurological Assessment

04 Prostate-Specific Antigen (PSA)

This brief evaluation of your mental functioning and nervous system can help detect origins of urinary problems aside from enlarged prostate.

If the above mentioned assessment and laboratory tests are remarkable or suggesting that you have an enlarged prostate, your physician may require additional conďŹ rmatory tests.

Urinary Flow Test You will be asked to urinate into a receptacle attached to a machine.

This measures the strength and amount of your urine ow.

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Benign Prostatic Hyperplasia Post Void Residual Volume Test Test can be done using ultrasound or by inserting a catheter into the bladder after urination to measure how much urine is left in the bladder. It detects whether you can entirely empty the bladder.

Time

Amount Leak Urge Voided Volume Present

Activity

Amount / Type of Intake

24-Hour Voiding Diary Recording the occurrence and quantity of urine might be helpful if more than one-third of your daily urinary output take place at night-time.

If the above mentioned assessment and laboratory tests are remarkable or suggesting that you have an enlarged prostate, your physician may require additional conďŹ rmatory tests.

Trans Rectal Ultrasound Transrectal Ultrasound is also called Prostate Sonogram or Endorectal Ultrasound. This is a diagnostic test using an ultrasound probe inserted into the rectum to measure and evaluate the prostate and its surrounding tissue.

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Benign Prostatic Hyperplasia

Prostate Biopsy A needle with the guidance of Trans Rectal ultrasound will be used to get a tissue sample of the prostate for examination.

The tissue can help your doctor diagnose or except prostate cancer.

Urodynamic and Pressure Flow Studies A catheter is threaded through the urethra then water and air will be injected into the bladder slowly.

This will measure bladder pressure and determine how well your bladder muscles are working.

Cystoscopy A thin tube with a camera and light on the end called a cystoscope is inserted into the urethra under local anesthesia.

This will let doctor visualize the urethra and bladder.

Intravenous Pyelogram or CT Urogram A tracer or an iodinated contrast is injected into a vein then an X-ray or CT scan is then taken of your kidneys, bladder and the tubes that join your kidneys to your bladder (ureters). These tests can help detect urinary tract stones, tumors or blockages above the bladder.

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Benign Prostatic Hyperplasia Benign Prostatic Hyperplasia Treatment Benign Prostatic Hyperplasia is treated through several treatment plans with the following order:

Regular medical follow-up with some lifestyle adjustments to reduce symptoms

Medical treatments that help reduce symptoms

Minor Surgeries

Advanced Surgeries

Reducing Benign Prostatic Hyperplasia Symptoms The ďŹ rst outlines to deal with simple conditions of enlarged prostate is through checking with your doctor to conďŹ rm the diagnosis and exclusion of any other possibilities and doing necessary tests to make sure there are no complications.

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Benign Prostatic Hyperplasia

Healthy Lifestyle during Benign Prostatic Hyperplasia Reduce drinking carbonated water and drinks containing caffeine.

Avoid drinking water an hour before bedtime to avoid frequent waking up

to urinate at night.

If the patient takes Diuretics, he should review his doctor to adjust medication times so as not to lead to increasing urinary symptoms of enlarged prostate, basic amendment is to make the drug dose far from bedtime at night.

Avoid excess use of decongestants drugs because they aggravate prostate symptoms.

Never lock up your urine for long period of time and respond quickly to

the desire to urinate.

Try to make daily routine for urinate times through getting used to go to

the bathroom every few hours.

Regular exercise helps to reduce prostate symptoms.

Get used to give enough time to urinate to make sure you completely get

rid of it.

Practice Double Voiding Urinate where the patient urinates twice in order

to make sure of entirely emptying urine.

Never rush during urination helps to reduce the problem of leaking of urine drops after the completion of urination.

Good warming and avoid exposure to cold helps to reduce the symptoms

of enlarged prostate.

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Benign Prostatic Hyperplasia Pharmacologic Treatment of BPH

Alpha-blockers (α-blockers) Medications

5 α Reductase Inhibitor Combination Treatment

PDE5 - I

Treatment of BPH by Surgery There are many ways in case of failing in treatment with drugs to control the symptoms of Benign Prostatic Hyperplasia, including: Transurethral Resection of the Prostate (TURP) Photoselective (Laser) Vaporization of the Prostate (PVP)

Open Prostatectomy

BPH and Erectile Dysfunction (ED) The mutual influence between Benign Prostatic Hyperplasia and the ED depends on the following factors: Continuous feeling of pain in the bladder and prostate area affects

enjoying sexual relationship.

Some medicines for prostate hormonal enlargement negatively affect lust.

Some treatment surgeries of benign prostatic hyperplasia have a negative impact on sexual performance for few weeks after the surgery.

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Benign Prostatic Hyperplasia Protection from BPH Although BPH is a part of the natural ageing process but there are some things that will help reducing the problem and most importantly: Exercising regularly.

Drinking enough uids throughout the day without profusion.

Getting used to go to the bathroom to urinate every three hours.

Avoid drinking uids containing caffeine such as coffee.

Maintaining a healthy weight and avoid obesity.

Good warming and avoid continuous exposure to cold unnecessarily.

Exercising pelvic muscles to prevent problem of leaking urine drops

suddenly.

Healthy nutrition containing fresh vegetables and fruits.

Regular periodic follow-up with your doctor helps early detection and

easily treatment.

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‫ص‪.‬ب‪ ،72772 :‬اﻟﺷﺎرﻗﺔ ‪ ،‬اﻹﻣﺎرات اﻟﻌرﺑﯾﺔ اﻟﻣﺗﺣدة‬ ‫ھﺎﺗف‪ ،+971 6 505 8555 :‬ﻓﺎﻛس‪+971 6 505 8444 :‬‬ ‫ﺑرﯾد إﻟﻛﺗروﻧﻲ‪ ،info@uhs.ae :‬اﻟﻣوﻗﻊ اﻹﻟﻛﺗروﻧﻲ‪www.uhs.ae :‬‬

‫‪/UHSharjah‬‬

‫‪/UHSharjah‬‬

‫‪/UniversityHospitalSharjah‬‬

‫‪/UHSharjah‬‬

‫ﻧﺗﻌﺎﻣل ﻣﻊ ﻣﻌظم ﺷرﻛﺎت اﻟﺗﺄﻣﯾن‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﻋﻼج ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﻷدوﯾﺔ‪:‬‬ ‫رﻏم أن ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ھو ﺟزء ﻣن ﻋﻣﻠﯾﺔ اﻟﺷﯾﺧوﺧﺔ اﻟطﺑﯾﻌﯾﺔ إﻻ أن ھﻧﺎك‬ ‫ﺑﻌض اﻷﺷﯾﺎء اﻟﺗﻲ ﺗﺳﺎﻋد ﻓﻲ ﺗﺧﻔﯾف ﺣدة اﻟﻣﺷﻛﻠﺔ وﻣن أھﻣﮭﺎ‪:‬‬ ‫ ‬

‫ﻣﻣﺎرﺳﺔ اﻟرﯾﺎﺿﺔ ﺑﺎﻧﺗظﺎم‪.‬‬

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‫ﺷرب ﻛﻣﯾﺎت ﻛﺎﻓﯾﺔ ﻣن اﻟﺳواﺋل ﻋﻠﻰ ﻣدار اﻟﯾوم دون إﺳراف‪.‬‬

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‫اﻟﺗﻌود ﻋﻠﻰ دﺧول اﻟﺣﻣﺎم ﻟﻠﺗﺑول ﻛل ‪ 3‬ﺳﺎﻋﺎت‪.‬‬

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‫ﻋدم اﻹﺳراف ﻓﻲ ﺗﻧﺎول اﻟﻣﺷروﺑﺎت اﻟﻣﺣﺗوﯾﺔ ﻋﻠﻰ ﻛﺎﻓﯾﯾن ﻣﺛل اﻟﻘﮭوة‪.‬‬

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‫اﻟﺣﻔﺎظ ﻋﻠﻰ اﻟوزن اﻟﺻﺣﻲ وﺗﺟﻧب اﻟﺳﻣﻧﺔ‪.‬‬

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‫اﻟﺗدﻓﺋﺔ اﻟﺟﯾدة وﺗﺟﻧب اﻟﺗﻌرض اﻟﻣﺳﺗﻣر ﻟﻠﺑرودة ﺑدون داﻋﻲ‪.‬‬

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‫ﻣﻣﺎرﺳﺔ ﺗﻣﺎرﯾن ﻋﺿﻼت اﻟﺣوض ﻟﻣﻧﻊ ﻣﺷﺎﻛل ﻧزول اﻟﺑول ﺑﺷﻛل ﻣﻔﺎﺟﺊ‪.‬‬

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‫اﻟﺗﻐذﯾﺔ اﻟﺻﺣﯾﺔ اﻟﺗﻲ ﺗﺣﺗوي ﻋﻠﻰ ﺧﺿراوات وﻓواﻛﮫ طﺎزﺟﺔ‪.‬‬

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‫اﻟﻣﺗﺎﺑﻌﺔ اﻟدورﯾﺔ اﻟﻣﻧﺗظﻣﺔ ﻣﻊ اﻟطﺑﯾب ﺗﺳﺎﻋد ﻋﻠﻰ اﻹﻛﺗﺷﺎف اﻟﻣﺑﻛر واﻟﻌﻼج‬ ‫ﺑﺳﮭوﻟﺔ‪.‬‬

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‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﻋﻼج ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﻷدوﯾﺔ‪:‬‬ ‫ ‬ ‫ ‬ ‫ ‬

‫أدوﯾﺔ ﻏﺎﻟﻘﺎت ﻣﺳﺗﻘﺑﻼت أﻟﻔﺎ‪.‬‬ ‫أدوﯾﺔ اﻟﻣﺛﺑطﺎت اﻟﮭرﻣوﻧﯾﺔ‪.‬‬ ‫أدوﯾﺔ اﻟﺳﯾﺎﻟس‪.‬‬

‫ﻋﻼج ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﻟﺟراﺣﺔ‪:‬‬

‫ھﻧﺎك طرق ﻋدﯾدة ﯾﺗم اﻟﻠﺟوء اﻟﯾﮭﺎ ﻓﻲ ﺣﺎﻟﺔ ﻓﺷل اﻟﻌﻼج ﺑﺎﻷدوﯾﺔ ﻓﻲ اﻟﺳﯾطرة ﻋﻠﻰ‬ ‫أﻋراض ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد وﻣﻧﮭﺎ‪:‬‬

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‫اﺳﺗﺋﺻﺎل اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﺳﺗﺧدام اﻟﻣﻧظﺎر اﻟﻛﮭرﺑﺎﺋﻲ‪.‬‬ ‫اﺳﺗﺋﺻﺎل اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﺳﺗﺧدام اﻟﻠﯾزر‪.‬‬ ‫اﺳﺗﺋﺻﺎل اﻟﺑروﺳﺗﺎﺗﺎ ﻋن طرﯾﻖ اﻟﻔﺗﺢ‪.‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد واﻟﺿﻌف اﻟﺟﻧﺳﻲ‬ ‫ﯾﻌﺗﻣد اﻟﺗﺄﺛﯾر اﻟﻣﺗﺑﺎدل ﺑﯾن ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد وﺑﯾن اﻟﺿﻌف اﻟﺟﻧﺳﻲ ﻋﻠﻰ‬ ‫اﻟﻣﺣﺎور اﻟﺗﺎﻟﯾﺔ‪:‬‬ ‫اﻟﺷﻌور اﻟﻣﺳﺗﻣر ﺑﺎﻷﻟم ﻓﻲ ﻣﻧطﻘﺔ اﻟﻣﺛﺎﻧﺔ واﻟﺑروﺳﺗﺎﺗﺎ ﯾؤﺛر ﻋﻠﻰ اﻹﺳﺗﻣﺗﺎع‬ ‫ﺑﺎﻟﻌﻼﻗﺔ اﻟﺟﻧﺳﯾﺔ‪.‬‬ ‫ﺑﻌض أدوﯾﺔ ﻋﻼج ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﮭرﻣوﻧﯾﺔ ﺗؤﺛر ﺳﻠﺑﺎ ﻋﻠﻰ اﻟرﻏﺑﺔ اﻟﺟﻧﺳﯾﺔ‪.‬‬ ‫ﺑﻌض اﻟﻌﻣﻠﯾﺎت ﻋﻼج ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ﯾﻛون ﻟﮭﺎ اﻧﻌﻛﺎس ﺳﻠﺑﻲ ﻋﻠﻰ‬ ‫اﻟﻘدرة اﻟﺟﻧﺳﯾﺔ ﻟﺑﺿﻌﺔ أﺳﺎﺑﯾﻊ ﺑﻌد اﻟﻌﻣﻠﯾﺔ‪.‬‬ ‫‪12‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬

‫ﻧﻣط اﻟﺣﯾﺎة اﻟﺳﻠﯾم ﻣﻊ ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬

‫ ﺗﻘﻠﯾل ﺷرب اﻟﻣﯾﺎه اﻟﻐﺎزﯾﺔ واﻟﻣﺷروﺑﺎت اﻟﺗﻲ ﺗﺣﺗوي ﻋﻠﻰ ﻛﺎﻓﯾﯾﻧن ﻋدم ﺷرب‬ ‫اﻟﻣﺎء ﻗﺑل اﻟﻧوم ﺑﺳﺎﻋﺔ ﻟﺗﺟﻧب اﻻﺳﺗﯾﻘﺎظ اﻟﻣﺗﻛرر ﻟﻠﺗﺑول ﻟﯾﻼً‪.‬‬ ‫ إذا أﺧذ اﻟﻣرﯾض ﺗﻧﺎول أدوﯾﺔ ﻣدره ﻟﻠﺑول ﯾﺟب ﻋﻠﯾﮫ أن ﯾراﺟﻊ طﺑﯾﺑﮫ ﻣن أﺟل‬ ‫ﺗﻌدﯾل ﻣواﻋﯾد اﻟدواء ﺣﺗﻰ ﻻ ﺗؤدي إﻟﻰ زﯾﺎدة اﻷﻋراض اﻟﺑوﻟﯾﺔ اﻟﺧﺎﺻﺔ ﺑﺗﺿﺧم‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ‪ ،‬واﻟﺗﻌدﯾل اﻷﺳﺎﺳﻲ ﯾﺗﻣﺛل ﻓﻲ ﺟﻌل ﺟرﻋﺔ اﻟدواء ﻓﻲ ﻣوﻋد ﺑﻌﯾد ﻋن ﻣوﻋد‬ ‫اﻟﻧوم ﻣﺳﺎءا‪.‬‬ ‫ ﺗﺟﻧب اﻹﺳراف ﻣن أدوﯾﺔ ﻣﺿﺎدات اﻹﺣﺗﻘﺎن ﻷﻧﮭﺎ ﺗؤدي إﻟﻰ ﺗﻔﺎﻗم أﻋراض‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬ ‫ ‬

‫ﻋدم ﺣﺑس اﻟﺑول ﻟﻔﺗرة طوﯾﻠﺔ واﻹﺳﺗﺟﺎﺑﺔ ﺑﺷﻛل ﺳرﯾﻊ ﻟﻠرﻏﺑﺔ ﻓﻲ اﻟﺗﺑول‪.‬‬

‫ ﻣﺣﺎوﻟﺔ ﻋﻣل روﺗﯾن ﻷوﻗﺎت اﻟﺗﺑول اﻟﯾوﻣﯾﺔ ﻣن ﺧﻼل اﻹﻋﺗﯾﺎد ﻋﻠﻰ اﻟذھﺎب ﻟﻠﺣﻣﺎم‬ ‫ﻛل ﺑﺿﻌﺔ ﺳﺎﻋﺎت‪.‬‬ ‫ ‬

‫اﻹﻧﺗظﺎم ﻓﻲ ﻣﻣﺎرﺳﺔ اﻟرﯾﺎﺿﺔ ﯾﺳﺎﻋد ﻓﻲ ﺗﺧﻔﯾف أﻋراض اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬

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‫اﻟﺗﻌود ﻋﻠﻰ ﻣﻧﺢ اﻟوﻗت اﻟﻛﺎﻓﻲ ﻟﻠﺗﺑول ﻟﻠﺗﺄﻛد ﻣن ﻧزوﻟﮫ ﺑﺎﻟﻛﺎﻣل‪.‬‬

‫ اﺳﺗﺧدام ﺗﻘﻧﯾﺔ اﻟﺗﺑول اﻟﻣزدوج ﺣﯾث ﯾﻘوم اﻟﻣرﯾض ﺑﺎﻟﺗﺑول ﻋﻠﻰ ﻣرﺗﯾن ﻣن أﺟل‬ ‫اﻟﺗﺄﻛد ﻣن ﺗﻔرﯾﻎ اﻟﺑول ﺑﺄﻛﻣﻠﮫ‪.‬‬ ‫ ﻋدم اﻹﺳﺗﻌﺟﺎل أﺛﻧﺎء اﻟﺗﺑول ﯾﺳﺎﻋد ﻋﻠﻰ ﺗﻘﻠﯾل ﻣﺷﻛﻠﺔ ﻧزول ﻗطرات اﻟﺑول ﺑﻌد‬ ‫اﻹﻧﺗﮭﺎء ﻣن اﻟﺗﺑول‪.‬‬ ‫ اﻟﺗدﻓﺋﺔ اﻟﺟﯾدة وﺗﺟﻧب اﻟﺗﻌرض ﻟﻠﺑرد ﯾﺳﺎﻋد ﻋﻠﻰ ﺗﺧﻔﯾف أﻋراض ﺗﺿﺧم‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬ ‫‪11‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫طرح ﻋﻼج اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬ ‫ﯾﺗم اﻟﺗﻌﺎﻣل ﻣﻊ ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ﻣن ﺧﻼل ﻋدة ﺧطط ﻋﻼﺟﯾﺔ ﺑﺎﻟﺗرﺗﯾب اﻟﺗﺎﻟﻲ‪:‬‬ ‫ اﻟﻣﺗﺎﺑﻌﺔ اﻟطﺑﯾﺔ اﻟﻣﻧﺗظﻣﺔ ﻣﻊ ﺑﻌض ﺗﻌدﯾﻼت ﻧﻣط اﻟﺣﯾﺎة ﻟﺗﺧﻔﯾف اﻷﻋراض‪.‬‬ ‫ اﻟﻌﻼﺟﺎت اﻟدواﺋﯾﺔ اﻟﺗﻲ ﺗﺳﺎﻋد ﻋﻠﻰ ﺗﺧﻔﯾف اﻷﻋراض‪.‬‬ ‫ اﻟﺟراﺣﺎت اﻟﺻﻐرى‪.‬‬ ‫ اﻟﺟراﺣﺎت اﻟﻣﺗﻘدﻣﺔ‪.‬‬

‫ﺗﺧﻔﯾف أﻋراض ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬

‫اﻟﺧطوط اﻷوﻟﻰ ﻟﻠﺗﻌﺎﻣل ﻣﻊ اﻟﺣﺎﻻت اﻟﺑﺳﯾطﺔ ﻣن ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ ﺗﻛون ﻣن‬ ‫ﺧﻼل ﻣراﺟﻌﺔ اﻟطﺑﯾب ﻣن أﺟل ﺗﺄﻛﯾد اﻟﺗﺷﺧﯾص واﺳﺗﺑﻌﺎد أي اﺣﺗﻣﺎﻻت أﺧرى‬ ‫وﻋﻣل اﻟﺗﺣﺎﻟﯾل اﻟﻼزﻣﺔ ﻟﻠﺗﺄﻛد ﻣن ﻋدم وﺟود أي ﻣﺿﺎﻋﻔﺎت‪.‬‬ ‫‪10‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﺧزﻋﺔ اﻟﺑروﺳﺗﺎﺗﺎ‬

‫ﺳﯾﺗم اﺳﺗﺧدام إﺑرة اﻋﺗﻣﺎدا ً ﻋﻠﻰ‬ ‫اﻟﻣوﺟﺎت ﻓوق اﻟﺻوﺗﯾﺔ ﻋﺑر اﻟﻣﺳﺗﻘﯾم‬ ‫ﻟﻠﺣﺻول ﻋﻠﻰ ﻋﯾﻧﺔ ﻷﻧﺳﺟﺔ‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ ﻟﻠﻔﺣص‪ .‬ﯾﻣﻛن أن ﺗﺳﺎﻋد‬ ‫اﻷﻧﺳﺟﺔ طﺑﯾﺑك ﺗﺷﺧﯾص أو ﺗوﻗﻊ‬ ‫ﺳرطﺎن اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬

‫دﯾﻧﺎﻣﯾﻛﯾﺔ اﻟﺗﺑول ودراﺳﺔ‬ ‫ﺗدﻓﻖ اﻟﺿﻐط‬

‫ﯾﺗم رﺑط اﻟﻘﺳطرة ﻣن ﺧﻼل ﻣﺟرى‬ ‫اﻟﺑول ﺛم ﺳﯾﺗم ﺣﻘن اﻟﻣﺎء واﻟﮭواء ﻓﻲ‬ ‫اﻟﻣﺛﺎﻧﺔ ﺑﺑطء‪ .‬ھذا اﻹﺟراء ﯾﻘﯾس ﺿﻐط‬ ‫اﻟﻣﺛﺎﻧﺔ وﯾﺣدد ﻣدى ﻋﻣل ﻋﺿﻼت‬ ‫اﻟﻣﺛﺎﻧﺔ اﻟﺧﺎﺻﺔ ﺑك‪.‬‬

‫ﺗﻧظﯾر اﻟﻣﺛﺎﻧﺔ‬

‫ﯾﺗم إدﺧﺎل أﻧﺑوب رﻓﯾﻊ ﻣﻊ ﻛﺎﻣﯾرا‬ ‫وﺿوء ﻋﻠﻰ اﻟﻧﮭﺎﯾﺔ وھو ﻣﺎ ﯾﺳﻣﻰ‬ ‫ﺑﻣﻧظﺎر اﻟﻣﺛﺎﻧﺔ ﻓﻲ ﻣﺟرى اﻟﺑول ﺗﺣت‬ ‫اﻟﺗﺧدﯾر اﻟﻣوﺿﻌﻲ‪ .‬وھذا ﺳوف ﯾﺳﻣﺢ‬ ‫ﻟﻠطﺑﯾب ﺗﺻور ﻣﺟرى اﻟﺑول واﻟﻣﺛﺎﻧﺔ‪.‬‬

‫ﺗﺻوﯾر اﻟﺟﮭﺎز اﻟﺑوﻟﻲ ﻋن طرﯾﻖ اﻟورﯾد‬ ‫أو ﻋن طرﯾﻖ اﻷﺷﻌﺔ اﻟﻣﻘطﻌﯾﺔ‬ ‫ﯾﺗم ﺣﻘن ﺟﮭﺎز اﻟﺗﺗﺑﻊ أو اﻟﺗﺑﺎﯾن ﺑﺎﻟﯾود ﻓﻲ‬ ‫اﻟورﯾد ﺛم ﯾﺗم أﺧذ اﻷﺷﻌﺔ اﻟﺳﯾﻧﯾﺔ أو‬ ‫اﻷﺷﻌﺔ اﻟﻣﻘطﻌﯾﺔ ﻣن ﻛل ﻣن اﻟﻛﻠﻰ‬ ‫واﻟﻣﺛﺎﻧﺔ واﻷﻧﺎﺑﯾب اﻟﺗﻲ ﺗوﺻل اﻟﻛﻠﯾﺗﯾن‬ ‫إﻟﻰ اﻟﻣﺛﺎﻧﺔ )اﻟﺣﺎﻟب(‪ .‬ھذه اﻻﺧﺗﺑﺎرات‬ ‫ﯾﻣﻛن أن ﺗﺳﺎﻋد ﻓﻲ اﻟﻛﺷف ﻋن ﺣﺻوات‬ ‫اﻟﻣﺳﺎﻟك اﻟﺑوﻟﯾﺔ‪ ،‬اﻷورام أو اﻻﻧﺳداد ﻓوق‬ ‫اﻟﻣﺛﺎﻧﺔ‪.‬‬ ‫‪9‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﻗﯾﺎس ﺣﺟم اﻟﺑول‬ ‫اﻟﻣﺗﺑ ِﻘّﻲ ﻓﻲ اﻟﻣﺛﺎﻧﺔ‬ ‫ﯾﻣﻛن أن ﯾﺗم اﻻﺧﺗﺑﺎر ﺑﺎﺳﺗﺧدام‬ ‫اﻟﻣوﺟﺎت ﻓوق اﻟﺻوﺗﯾﺔ أو ﻋن‬ ‫طرﯾﻖ إدﺧﺎل اﻟﻘﺳطرة ﻓﻲ‬ ‫اﻟﻣﺛﺎﻧﺔ ﺑﻌد اﻟﺗﺑول ﻟﻘﯾﺎس ﻣدى‬ ‫ﺣﺟم اﻟﺑول اﻟﻣﺗﺑﻘﻰ ﻓﻲ اﻟﻣﺛﺎﻧﺔ‪.‬‬ ‫ﺣﯾث أﻧﮫ ﯾﻛﺷف ﻣﺎ إذا ﻛﺎن‬ ‫ﯾﻣﻛﻧك ﺗﻔرﯾﻎ اﻟﻣﺛﺎﻧﺔ ﺑﺎﻟﻛﺎﻣل‪.‬‬

‫اﻟﻮﻗﺖ اﻟﻜﻤﻴﺔ ﺣﺠﻢ اﻟﺮﻏﺒﺔ‬ ‫اﻟﺘﺒﻮل اﻟﻨﺸﺎط‬ ‫اﳌﻔﺮﻏﺔ اﻟﺘﻔﺮﻳﻎ ﰱ‬

‫ﺣﺠﻢ‪ /‬ﻧﻮع‬ ‫اﻹدﺧﺎل‬

‫ﺗﺳﺟﯾل ﺗﻔرﯾﻎ اﻟﻣﺛﺎﻧﺔ‬ ‫ﻟﻣدة ‪ 24‬ﺳﺎﻋﺔ‬ ‫ﻗد ﯾﻛون ﻣن اﻟﻣﻔﯾد ﺗﺳﺟﯾل‬ ‫ﺣدوث وﻛﻣﯾﺔ اﻟﺑول إذا ﻛﺎن‬ ‫أﻛﺛر ﻣن ﺛﻠث اﻟﻧﺎﺗﺞ اﻟﯾوﻣﻰ‬ ‫ﻟﻠﺑول ﯾﺣدث ﻓﻰ اﻟﻠﯾل‪.‬‬

‫ﻗد ﯾﺧﺗﺎر طﺑﯾﺑك أن ﯾوﺻﻲ ﺑﻌﻣل اﻹﺟراءات اﻟﺗﺎﻟﯾﺔ واﺟراء ﻓﺣص ﺗﺷﺧﯾﺻﻰ‬ ‫إذا ﻛﺎﻧت ﺣﺎﻟﺗك ﻣﻌﻘدة ﻟﻠﻐﺎﯾﺔ‪:‬‬

‫اﻟﻣوﺟﺎت ﻓوق اﻟﺻوﺗﯾﺔ‬ ‫ﻋﺑر اﻟﻣﺳﺗﻘﯾم‬ ‫ﯾﺳﻣﻰ ﻓﺣص اﻟﻣوﺟﺎت ﻓوق‬ ‫اﻟﺻوﺗﯾﺔ ﻋﺑر اﻟﻣﺳﺗﻘﯾم أﯾﺿﺎ ً‬ ‫ﺑﻔﺣص اﻟﺑروﺳﺗﺎﺗﺎ ﺑﺎﻟﻣوﺟﺎت‬ ‫اﻟﺻوﺗﯾﺔ أو ﻓﺣص ﻧﮭﺎﯾﺔ اﻟﻣﺳﺗﻘﯾم‬ ‫ﺑﺎﻟﻣوﺟﺎت ﻓوق اﻟﺻوﺗﯾﺔ‪ .‬ﯾﺗم ھذا‬ ‫اﻻﺧﺗﺑﺎر ﺑﺎدﺧﺎل ﻣﺳﺑﺎر اﻟﻣوﺟﺎت‬ ‫ﻓوق اﻟﺻوﺗﯾﺔ ﻓﻲ اﻟﻣﺳﺗﻘﯾم ﻟﻘﯾﺎس‬ ‫وﺗﺣﻠﯾل اﻟﺑروﺳﺗﺎﺗﺎ واﻷﻧﺳﺟﺔ‬ ‫اﻟﻣﺣﯾطﺔ ﺑﮭﺎ‪.‬‬ ‫‪8‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬

‫‪03‬‬ ‫اﺧﺘﺒﺎر اﻟﺪم‬

‫وﺗﺷﻣل اﺧﺗﺑﺎرات اﻟدم‬ ‫اﻟﻛرﯾﺎﺗﯾﻧﯾن و ﻧﯾﺗروﺟﯾن‬ ‫ﯾورﯾﺎ اﻟدم ﻟﻠﻛﺷف ﻋن أي‬ ‫ﺗﻠف ﻓﻰ اﻟﻛﻠﻰ‪.‬‬

‫ﯾﺗﺿﻣن اﻻﺧﺗﺑﺎر ﺳﺣب اﻟدم ﻣن‬ ‫اﻟذراع‪ ،‬ﻣﺛل اﺧﺗﺑﺎر اﻟدم اﻟﻣﻌﺗﺎد‪.‬‬ ‫ﺳﯾﺗم إرﺳﺎل ﻋﯾﻧﺔ اﻟدم إﻟﻰ‬ ‫اﻟﻣﺧﺗﺑر ﻟﺗﺣﻠﯾﻠﮭﺎ وﻏﺎﻟﺑﺎ ً ﻣﺎ ﺗظﮭر‬ ‫اﻟﻧﺗﺎﺋﺞ ﻓﻲ ﻏﺿون ﻋدة أﯾﺎم‪.‬‬ ‫اﻟﻣﺳﺗﺿد اﻟﺑروﺳﺗﺎﺗﻲ اﻟﻧوﻋﻲ ھو‬ ‫ﺑروﺗﯾن ﺗﻧﺗﺟﮫ ﺧﻼﯾﺎ ﻏدة‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ‪ .‬ارﺗﻔﺎع ﻣﺳﺗوﯾﺎت‬ ‫اﻟﻣﺳﺗﺿد اﻟﺑروﺳﺗﺎﺗﻲ اﻟﻧوﻋﻲ‬ ‫ﺗﺷﯾر إﻟﻰ ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬

‫‪05‬‬ ‫اﻟﺘﻘﻴﻴﻢ‬ ‫اﻟﻌﺼﺒﻲ‬

‫‪04‬‬

‫اﻟﻤﺴﺘﻀﺪ‬ ‫اﻟﺒﺮوﺳﺘﺎﺗﻲ‬ ‫اﻟﻨﻮﻋﻲ‬

‫ھذا اﻟﺗﻘﯾﯾم اﻟﻣﺧﺗﺻر ﻟﻧﺷﺎطك‬ ‫اﻟذھﻧﻰ وﺟﮭﺎزك اﻟﻌﺻﺑﻲ‬ ‫ﯾﻣﻛن أن ﯾﺳﺎﻋد ﻓﻲ اﻟﻛﺷف‬ ‫ﻋن أﺻول اﻟﻣﺷﺎﻛل اﻟﺑوﻟﯾﺔ‬ ‫اﻟﻰ ﺟﺎﻧب ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ‪.‬‬

‫إذا ﻛﺎن ھﻧﺎك ﻣﻼﺣظﺎت ﻓﻰ اﻟﺗﻘﯾﯾم واﻟﻔﺣوﺻﺎت اﻟﻣﻌﻣﻠﯾﺔ اﻟﻣذﻛورة أﻋﻼه أو أﻧﮭﺎ‬ ‫ﺗﺷﯾر إﻟﻰ أن ﻟدﯾك ﺗﺿﺧم ﻓﻰ اﻟﺑروﺳﺗﺎﺗﺎ‪ ،‬ﻗد ﯾﺣﺗﺎج اﻟطﺑﯾب إﻟﻰ اﺧﺗﺑﺎرات ﺗﺄﻛﯾدﯾﺔ‬ ‫إﺿﺎﻓﯾﺔ‪.‬‬

‫اﺧﺗﺑﺎر ﺗدﻓﻖ اﻟﺑول‬ ‫ﺳوف ﯾُطﻠب ﻣﻧك اﻟﺗﺑول ﻓﻲ‬ ‫وﻋﺎء ﻣﻌﻠﻖ ﻋﻠﻰ ﺟﮭﺎز‪ .‬ھذا‬ ‫ﯾﻘﯾس ﻗوة وﻛﻣﯾﺔ ﺗدﻓﻖ اﻟﺑول‬ ‫اﻟﺧﺎص ﺑك‪.‬‬

‫‪7‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫اﻻﺧﺗﺑﺎر واﻟﺗﺷﺧﯾص‪:‬‬

‫ﺑﺎدئ ذي ﺑدء‪ ،‬ﺳوف ﯾطﻠب طﺑﯾﺑك ﺗﺎرﯾﺧك اﻟطﺑﻲ اﻟدﻗﯾﻖ اﻟذي ﯾﺗﺿﻣن اﻷﻋراض‬ ‫واﻟﺗﻘﯾﯾم اﻟﺑدﻧﻲ‪ .‬اﻟﺗﻘﯾﯾم اﻟﺑدﻧﻲ اﻟذي ﺳﯾﻘوم ﺑﮫ طﺑﯾﺑك ھو ﻣﺎ ﯾﻠﻲ‪:‬‬

‫‪01‬‬

‫ﻓﺤﺺ‬ ‫اﻟﻤﺴﺘﻘﻴﻢ‬ ‫اﻟﺮﻗﻤﻲ‬

‫ﯾﺗم ھذا اﻻﺟراء ﻣن‬ ‫ﻗﺑل اﻟطﺑﯾب ﻋن طرﯾﻖ‬ ‫ادﺧﺎل اﻹﺻﺑﻊ ﻓﻲ‬ ‫اﻟﻣﺳﺗﻘﯾم ﻟﻔﺣص اﻟﺑروﺳﺗﺎﺗﺎ‬ ‫اﻟﻣﺗﺿﺧﻣﺔ‪.‬‬

‫ﻓﺣص ﻋﯾﻧﺔ ﻣن اﻟﺑول‬ ‫اﻟﺧﺎص ﺑك ﯾﻣﻛن أن‬ ‫ﯾﺳﺗﺑﻌد ﻋدوى أو ﻏﯾرھﺎ‬ ‫ﻣن اﻟﺣﺎﻻت اﻟﺗﻲ ﯾﻣﻛن أن‬ ‫ﺗﺳﺑب أﻋراض ﻣﻣﺎﺛﻠﺔ‪.‬‬

‫‪6‬‬

‫‪02‬‬ ‫اﺧﺘﺒﺎر اﻟﺒﻮل‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫أﻋراض ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬

‫ﺗظﮭر اﻷﻋراض ﻧﺗﯾﺟﺔ إﻧﺳداد ﻋﻧﻖ اﻟﻣﺛﺎﻧﺔ ﺑﻔﻌل ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ‪ ،‬ﺗﺧﺗﻠف ﺷدة‬ ‫اﻷﻋراض ﻟدى اﻷﺷﺧﺎص اﻟذﯾن ﻟدﯾﮭم ﺗﺿﺧم ﻓﻰ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ ‪ ،‬وﻟﻛن ﺗﻣﯾل‬ ‫اﻷﻋراض إﻟﻰ أن ﺗزداد ﺳوءا ً ﺗدرﯾﺟﯾﺎ ً ﻣﻊ ﻣرور اﻟوﻗت‪ .‬وﺗﺷﻣل اﻟﻌﻼﻣﺎت واﻷﻋراض‬ ‫اﻟﺷﺎﺋﻌﺔ ﻟﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد اﻵﺗﻰ‪:‬‬ ‫ ﺑطﺊ أو ﺿﻌف ﺧروج اﻟﺑول‪.‬‬ ‫ ﺗوﻗف اﻟﺑول وﻋودﺗﮫ ﻋدة ﻣرات أﺛﻧﺎء اﻟﺗﺑول‪.‬‬ ‫ زﯾﺎدة ﻣﻌدل اﻟﺗﺑول اﻟﻠﯾﻠﻲ‪.‬‬ ‫ ﻋدم اﻟﻘدرة ﻋﻠﻰ ﺗﻔرﯾﻎ اﻟﻣﺛﺎﻧﺔ ﺑﺎﻟﻛﺎﻣل‪.‬‬ ‫ ﻧزول ﻧﻘط ﻣن اﻟﺑول ﺑﺷﻛل ﻣﺗﻛرر‪.‬‬

‫ﻣﺿﺎﻋﻔﺎت ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬ ‫ ‬ ‫ ‬ ‫ ‬ ‫ ‬

‫ﻋدوى اﻟﻣﺳﺎﻟك اﻟﺑوﻟﯾﺔ‬ ‫اﺣﺗﺑﺎس اﻟﺑول اﻟﻣﻔﺎﺟﺊ‬ ‫ﺣﺻوات اﻟﻣﺛﺎﻧﺔ‬ ‫ﻣﺿﺎﻋﻔﺎت ﻓﻲ اﻟﻛﻠﻰ واﻟﻣﺛﺎﻧﺔ اﻟﺑوﻟﯾﺔ ﻧﺗﯾﺟﺔ ﺗراﻛم ﻛﻣﯾﺎت ﻛﺑﯾرة ﻣن اﻟﺑول ﻓﻲ‬ ‫اﻟﺟﮭﺎز اﻟﺑوﻟﻰ اﻟداﺧﻠﻰ‪.‬‬ ‫‪5‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﻣﺎ ھو ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد؟‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ھو ﺗﺿﺧم ﻓﻲ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ‪ .‬ﺗﺣدث ھذه اﻟﺣﺎﻟﺔ اﻟطﺑﯾﺔ‬ ‫ﻋﻧدﻣﺎ ﺗﺑدأ ﺧﻼﯾﺎ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ ﻓﻲ اﻟﺗﻛﺎﺛر‪ .‬ﺗؤدى ھذه اﻟﺧﻼﯾﺎ اﻹﺿﺎﻓﯾﺔ اﻟﻰ ﺗﺿﺧم‬ ‫ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ ﻣﻣﺎ ﯾﺿﻐط ﻋﻠﻰ ﻣﺟرى اﻟﺑول وﯾﺣد ﻣن ﺗدﻓﻖ اﻟﺑول‪.‬‬

‫أﺳﺑﺎب ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‪:‬‬ ‫ﯾﻌﺗﺑر ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ﺟزء ﻣن ﻋﻣﻠﯾﺔ اﻟﺷﯾﺧوﺧﺔ اﻟطﺑﯾﻌﯾﺔ ﻟدى اﻟرﺟﺎل‪،‬‬ ‫ﺗﺣدث ﻧﺗﯾﺟﺔ ﺗﻐﯾرات ﻓﻲ اﻟﺗوازن اﻟﮭرﻣوﻧﻲ وﻓﻲ ﻧﻣو اﻟﺧﻼﯾﺎ‪ .‬ﺣﯾث ﺗﺻل ﻧﺳﺑﺗﮫ‬ ‫ﻋﻧد اﻟرﺟﺎل ﻓوق ‪ 60‬ﺳﻧﺔ إﻟﻰ ‪ 50%‬وﺗﺻل إﻟﻰ ‪ 90%‬ﺑﺎﻟﻧﺳﺑﺔ ﻟﻠرﺟﺎل ﻓوق‬ ‫‪ 85‬ﺳﻧﺔ‪.‬‬ ‫وأﺳﺑﺎب ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ﻏﯾر واﺿﺣﺔ ﺑﺷﻛل ﻛﺎﻣل وﻟﻛن ھﻧﺎك ﺑﻌض‬ ‫اﻟدراﺳﺎت اﻟﻌﻠﻣﯾﺔ اﻟﺗﻰ اﻗﺗرﺣت أن ذﻟك ﯾﺣدث ﻷن اﻟﻧﺳﺑﺔ اﻟﻌﺎﻟﯾﺔ ﻣن ھرﻣون‬ ‫اﻻﺳﺗروﺟﯾن داﺧل اﻟﺑروﺳﺗﺎﺗﺎ ﺗزﯾد ﻣن ﻧﺷﺎط اﻟﻣواد اﻟﺗﻲ ﺗﻌزز ﻧﻣو ﺧﻼﯾﺎ‬ ‫اﻟﺑروﺳﺗﺎﺗﺎ‪ .‬ﯾُﻧﺗﺞ اﻟرﺟﺎل اﻟﺗﺳﺗوﺳﺗﯾرون )ھرﻣون اﻟذﻛورة( وﻛﻣﯾﺔ ﺻﻐﯾرة ﻣن‬ ‫ھرﻣون اﻻﺳﺗروﺟﯾن )ھرﻣون اﻷﻧﺛﻰ(‪ .‬وﻣﻊ ﺗﻘدم اﻟﺳن‪ ،‬ﺗﻘل ﻛﻣﯾﺔ ھرﻣون‬ ‫اﻟﺗﺳﺗوﺳﺗﯾرون اﻟﻧﺷط ﻓﻲ اﻟدم ﻣﻣﺎ ﯾﺗرك ﻧﺳﺑﺔ أﻋﻠﻰ ﻣن ھرﻣون اﻻﺳﺗروﺟﯾن‪.‬‬ ‫‪4‬‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬ ‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ اﻟﺣﻣﯾد ھو ﺗﺿﺧم ﯾﺣدث ﻓﻰ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ‪ ،‬ﺣﯾث ﯾُﺻﺎب ﺑﮫ‬ ‫رﺟل ﻣن ﻛل ﺛﻼث رﺟﺎل ﺑﻌد ﺳن اﻟﺧﻣﺳﯾن‪.‬‬

‫ﻣﺎھﻲ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ؟‬

‫اﻟﺑروﺳﺗﺎﺗﺎ ھﻰ ﻏدة ﻓﻲ ﺣﺟم وﺷﻛل ﺣﺑﺔ اﻟﺟوز اﻟﺻﻐﯾرة ﺗﻘﻊ ﺑﯾن اﻟﻣﺛﺎﻧﺔ واﻟﻘﺿﯾب‪.‬‬ ‫ﺣﯾث ﺗﻘﻊ أﻣﺎم اﻟﻣﺳﺗﻘﯾم ﺗﻣﺎﻣﺎً‪ .‬ﯾﻣر ﻣﺟرى اﻟﺑول ﻋﺑر ﻣرﻛز اﻟﺑروﺳﺗﺎﺗﺎ‪ ،‬ﻣن اﻟﻣﺛﺎﻧﺔ إﻟﻰ‬ ‫اﻟﻘﺿﯾب‪ ،‬ﻣﻣﺎ ﯾﺳﻣﺢ ﺑﺗدﻓﻖ اﻟﺑول ﻣن اﻟﺟﺳم‪.‬‬

‫ﻣﺎھﻲ وظﯾﻔﺔ ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ؟‬

‫ﺗﻌرف اﻟﺑروﺳﺗﺎﺗﺎ ﻋﻠﻰ أﻧّﮭﺎ ﻏدّة ذﻛرﯾﺔ ﺗﻧﺎﺳﻠﯾﺔ ﺗﺗﻣﺛل وظﯾﻔﺗﮭﺎ اﻷﺳﺎﺳﯾﺔ ﻓﻰ ﺗدﻓﻖ‬ ‫ّ‬ ‫اﻟﺳﺎﺋل اﻟﻣﻧوى‪ .‬ﺗﺳﺎﻋد ﻋﺿﻼت ﻏدة اﻟﺑروﺳﺗﺎﺗﺎ أﯾﺿﺎ ً ﻋﻠﻰ دﻓﻊ اﻟﺳﺎﺋل اﻟﻣﻧوي ﻧﺣو‬ ‫ﻣﺟرى اﻟﺑول أﺛﻧﺎء اﻟﻘذف‪.‬‬ ‫ﺗﻠﻌب اﻹﻓرازات اﻟﺑروﺳﺗﺎﺗﯾﺔ أﯾﺿﺎ ً دورا ﻗﯾﻣﺎ ً ﻣن ﺧﻼل ﺣﻣﺎﯾﺔ ﻣﺟرى اﻟﺑول ﻣن‬ ‫اﻟﺗﮭﺎﺑﺎت اﻟﻣﺳﺎﻟك اﻟﺑوﻟﯾﺔ‪.‬‬ ‫‪3‬‬

‫ﻗﺳم اﻟﻣﺳﺎﻟك اﻟﺑوﻟﯾﺔ‬

‫ﺗﺿﺧم اﻟﺑروﺳﺗﺎﺗﺎ‬ ‫اﻟﺣﻣﯾد‬

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