Anatomical proximity of the prostate gland and colon, common innervation, blood and lymph circulation create prerequisites for the involvement of the intestine in the pathological process in prostate diseases.
Aim To evaluate the effectiveness of preventive treatment of chronic constipation (CC) with the use of partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) in patients with benign prostatic hyperplasia (BPH) who are shown to have a prostate tour and its effect on the course of the postoperative period.
Materials and methods. We examined 60 patients with BPH who were referred for surgical treatment (transurethral resection of the prostate), who had chronic functional constipation. By random sampling, the patients were divided into two groups of 30 people. In group 1, standard preparation for surgical treatment was carried out for 1 month. In group 2, patients, in combination with standard preparation for surgical treatment, took partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) with food for the first 3 days – 1 sachet (5 g) per day, from the 4th to the 6th day – 2 sachets per day. From day 7, patients in group 2 were divided into two subgroups. In subgroup 2a, patients whose bowel function returned to normal continued taking the drug at a dose of 2 sachets per day. Those patients in whom the effect of restoring the regularity of bowel function was not satisfactory, took 3 sachets a day from the 7th day and were assigned to subgroup 2b. In the preoperative period, patients were examined on the 1st day (visit 1), 15th day (visit 2) and 30th day (visit 3) of observation. The average number of acts of defecation during the previous week, the severity and dynamics of clinical manifestations of constipation were evaluated on the basis of the Patient Assessment of Constipation Symptoms (PAC-SYM questionnaire), according to the totality of symptoms in points, as well as for each criterion separately. Evaluation of the effectiveness of treatment in the postoperative period was carried out on the basis of dynamic observation for 5–7 days.
Results. Initially, all patients in the two groups had signs characteristic of BPH and chronic functional constipation, the groups were homogeneous. According to the results obtained in group 1 for 30 days of follow-up before surgery, none of the studied parameters significantly changed (p0.05). In group 2, after 15 days of follow-up, a significant (p0.05) positive dynamics was revealed for all the studied indicators, both in comparison with group 1 and in comparison with the results obtained at visit 1. By visit 3, despite the absence of statistically significant dynamics in the indicators of both group 1 and group 2, in comparison with visit 2, significant (p0.05) differences remained between the groups. During the study, subgroup 2a included 19 patients who took 2 sachets of OptiFiber® per day, and subgroup 2b included 11 men who took 3 sachets per day from the 7th day of observation. Restoration of intestinal motility in patients taking dietary fiber occurred at an earlier time, while the differences were also statistically significant (p0.05). In group 1, 14 cases of early postoperative complications were registered, and in group 2–9 cases, which is 35.7% less. The number of cases of antibiotic-associated diarrhea in group 1 was 3, while in group 2 there was 1 such case, which is 66.7% less. When analyzing the results obtained, there were no significant differences in the studied parameters in the postoperative period between subgroups 2a and 2b. All 30 (100%) patients of group 2 gave a positive review of partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®), and plan to continue taking them after completing participation in the study.
Conclusion. Thus, according to the results of the study, we consider it appropriate to use partially hydrolyzed dietary fibers of cyamopsis tetrahedral (OptiFiber®) in the treatment of CC in patients with BPH who are shown to have a prostate tour as a means to effectively eliminate the manifestations of CC, improve the results of surgical treatment and improve the quality of life of this category of patients.
