Benign prostatic hyperplasia (BPH), referred to as prostatic hyperplasia, is a pathological manifestation of cellular hyperplasia and is a common condition in older men. It is now recognized that old age and functioning testes are two important factors in the development of BPH.
I. Clinical manifestations:
Early symptoms: frequent urination, more pronounced at night
The most important symptom: difficulty in urination, slow progression of the disease
Obstructive symptoms: waiting for urine, thin and weak urine line, short distance, effort to urinate, dribbling after urination, feeling of incomplete urination
Irritation symptoms: urinary urgency, urinary frequency, increased nocturia
Complications:
1, when the obstruction is aggravated to a certain extent, too much residual urine, gradually occurring urinary retention and overflow incontinence.
2, prostatic hyperplasia combined with infection or stones, can appear obvious urinary frequency, urinary urgency, urinary pain symptoms, and may appear hematuria;
3, obstruction caused by serious hydronephrosis, renal function damage, chronic renal insufficiency;
4, long-term urinary difficulties lead to increased abdominal pressure, can also cause inguinal hernia, internal hemorrhoids, etc.
Third, treatment:
1, wait for observation: most patients with prostate enlargement symptoms are mild, does not affect life and sleep
Generally, no treatment is needed and can wait for observation. If the symptoms worsen, you should choose other methods of treatment
2. Drug treatment:
Alpha blockers: non-selective alpha blockers: phenazopyridine; selective alpha1 receptor blockers, short-acting: prazosin, afuzosin; long-acting: terazosin, doxazosin; long-acting super-selective alpha1A receptor blockers: tamsulosin
5 alpha reductase inhibitors: finasteride
Combination of drugs is better than single drugs
3.Surgical treatment Mainly suitable for patients with moderate or severe BPH, currently most of them adopt minimally invasive surgical methods?with high safety.
Surgical treatment is recommended when BPH leads to the following complications:
1. Recurrent urinary retention (inability to urinate after at least one extubation or two);
2. Recurrent hematuria, which is not treated with 5α reductase inhibitors;
3.Recurrent urinary tract infection;
4.Bladder stone;
5, secondary upper urinary tract hydrocele (with or without renal impairment);
6, BPH patients combined with large bladder diverticulum, inguinal hernia, severe hemorrhoids or prolapse, clinical judgment without lifting the lower urinary tract obstruction to achieve the therapeutic effect, should consider surgical treatment.