Scientific understanding of prostate diseases (prostatitis, prostate hyperplasia, prostate cancer) Does prostatitis affect sexual function and fertility? Does an enlarged prostate mean prostate hyperplasia? Is prostate cancer a terminal disease? Can Chinese medicine treat these diseases? Below is the entire draft of the interview and the video URL. Video: Host: Prostatitis is a common disease in young and middle-aged men, prostate enlargement is a common disease in older men, and the incidence of prostate cancer has gradually increased in China in recent years. What causes these diseases? And how should they be diagnosed and prevented? This is a problem that many people are concerned about, and today we have invited the director to explain the various misconceptions about the treatment of prostate disease, so that people can treat prostate disease scientifically. The actual fact is that you can find a lot of different kinds of advertisements for the treatment of prostate disease in various channels. This is also an indication that prostate disease is a common disease and a headache for many people. The first thing you need to know is where the prostate gland is located. The prostate gland is part of the male genitourinary system, similar in shape and size to a chestnut, located below the bladder, above the genitourinary diaphragm, behind the root of the penis, behind the rectum, in front of the pubic bone, with the urethra passing through its center and the ejaculatory duct opening in it. The prostate gland is connected to the testes through the vas deferens, which produce sperm and secrete androgens. Semen is composed of spermatozoa and seminal plasma, which is produced by the prostate, seminal vesicle and urethral bulb glands. The prostate gland accounts for 30% of the entire semen. The prostate gland is physiologically involved in semen formation, and is not necessarily related to sexual function, kidney function, or sexually transmitted diseases. The actual fact is that there is no definite link between them. The idea that almost all male diseases are now linked to the prostate is not correct due to the misconceptions induced by it. Enlarged prostate and prostate cancer can compress the urethra and cause difficulty in urination; inflammation of the prostate, which can lead to urination-related symptoms and symptoms of perineal discomfort. Often in outpatient clinics you see people come in and say, “I have a prostate.” In fact, all men have a prostate, but not necessarily all have a disease. The host: Prostatitis, a common disease in men, is now also becoming more and more of a topic of discussion. This is because more and more people are suffering from this disease at the moment. The actual fact is that this is a kind of disease? The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The first one is the abnormal urination, the most common is incomplete urination, frequent urination is rare urinary urgency pain, the second is pain, pain in the small abdomen, lumbar sacral, perineum, scrotum, the third is anxiety, depression, obsessive-compulsive disorder and other psychological and mental disorders. This is mainly caused by long-term chronic discomfort and pain, as well as misconceptions and concerns about the disease, and inappropriate propaganda in the media adds to the burden of patients. The actual fact is that you can find a lot of people who are worried about their sexual and reproductive functions after having prostatitis. The actual fact is that the actual fact is that the particulars of the actuals are not really a lot of. The actual fact is that you will be able to get a lot more than just a few of these. For example, a person with prostatitis may also smoke, drink alcohol, be obese, etc., have had mumps and epididymitis in the past, all of which may affect the quality and quantity of sperm. Mature sperm are stored inside the epididymis, and prostate fluid only mixes with sperm at the moment of ejaculation and does not affect the quantity of sperm. A few patients may have affected the liquefaction of semen. If you suspect, you can have your semen routine tested. Even if there are abnormalities, they are not necessarily caused by prostatitis. Every year the European Urological Association, the American Urological Association and the Chinese Urological Association publish updates to their guidelines on prostatitis, and I often look through international journals, but as of today there is no official and definitive evidence that prostatitis affects fertility or sexual function. The actual fact is that you can find a lot of people who are afraid of the disease from the lack of medical knowledge, many patients do not have enough awareness of their own body abnormalities, and do not go to the hospital to confirm the diagnosis, but believe in the so-called false advertising, do some of the wrong treatment to delay the disease. The actual fact is that if you go to a regular hospital to do a corresponding examination, the doctor will be able to confirm whether you are suffering from prostatitis, and you don’t need to be deceived by false advertisements to spend unjust money to take the wrong road. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The main cause of acute prostatitis is due to urinary tract infection, but it can also be introduced by the bloodstream route and direct spread of inflammation from neighboring organs. The pathogenic bacteria are mainly E. coli. Acute prostatitis is rare in clinical practice. The actual fact is that you can find a lot of bacteria in the prostate fluid that can cause the disease. The non-bacterial prostatitis is divided into type IIIA and type IIIB. Type 3A has negative bacterial culture, but the prostate fluid is abnormally leukocytic, and type 3B has symptoms of prostatitis, but the prostate fluid is normal and the bacterial culture is negative. Asymptomatic prostatitis. There are no subjective symptoms and only evidence of inflammation is found when tests are performed on the prostate. Patients who are suspected of having prostatitis can have ultrasound, urinalysis, routine prostate fluid examination, and bacterial culture. The actual fact is that you can get a lot more than just a few of these. Moderator: What is the most common type in life? The most common type is Type III, which accounts for 80% of all chronic prostatitis patients. Type IIIA belongs to this type, you can first take oral antibiotics for 2~4 weeks, and then decide whether to continue antibiotic treatment according to its efficacy feedback. Moderator: After hearing you say that, I suddenly want to ask you a question. The prostatitis is very detailed, so different causes and different conditions should be targeted at different treatment methods. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The most common phrase you’ll see is “one goodbye to urinary frequency and urgency” These advertisements make many people pay a painful price for believing in them easily. How do you feel about this phenomenon? Director Gong: There are different treatments for the same disease, different methods have different advantages and disadvantages, different doctors have different choices, and different choices have different justifications. The choice of treatment method also needs to take into account the patient’s age and physical condition, family economy, personal wishes and the doctor’s proficiency and the hospital’s basic hardware. The doctor should recommend to the patient a scientific and formal treatment method that has proven to be effective. Any treatment method is clinically proven to be effective or ineffective, safe or unsafe by millions of patients, and doctors are obliged to provide transparent information to them and respect the patients’ right to know and choose. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual fact is that you can find a lot of people who are in a hurry to get the job done. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The goal of treatment for chronic prostatitis is to relieve pain, improve urinary symptoms and improve quality of life, and the evaluation of efficacy should be based on symptom improvement, which is a curable disease. In addition to proper understanding of the disease and lifestyle adjustments, appropriate medication can be taken. Combined with the presence of bacterial infection and related symptoms, antibiotics, alpha-blockers and NSAIDs can be used. Antibiotics can be chosen from quinolones, such as e.g. ciprofloxacin, levofloxacin, lomefloxacin and moxifloxacin, and also drugs such as sulfonamides (e.g. cotrimoxazole). If you have mycoplasma or chlamydia infection, you can use tetracyclines (such as minocycline, etc.) or macrolides, etc. I need to emphasize the point that evidence of bacterial infection is to be treated with antibiotics, which can be taken orally, with a sufficient course of treatment ranging from 2-6 weeks. The treatment guidelines do not recommend intraprostatic injection drug therapy, and I have seen many such patients clinically who have injected any drug into the interior of the prostate, so much so that it has led to chemical prostatitis. A patient who had an MRI of the prostate showed changes in the prostate and surrounding muscle tissue that were damaging, making treatment more difficult. In improving urination-related symptoms, different alpha-blockers can be chosen depending on the patient’s condition, such as doxazosin (Cordovan), napradil (Natal), tamsulosin (Harle) and terazosin (Gottlieb). Non-steroidal anti-inflammatory analgesics, which can improve pain symptoms, can be used, such as Loxone, Fenbendazole and Celecoxib, which also have a positive effect on disease recovery. Other treatments, such as biofeedback therapy, are non-invasive and optional. Heat therapy, although it has a certain effect on symptom relief in the short term, but there is a lack of long-term follow-up data, and it is not recommended for unmarried and infertile people. There are no “herbal medicines” in Western countries, but there are botanicals, either as individual plant extracts or as mixtures of plants. These drugs still have a good market in Europe, are FDA approved and are widely used around the world. For example: Lutetide: the ingredient St? John’s Wort extract, which can be used in the treatment of depression. Spironolactone: It is an extract of various plants and can be used for respiratory infections caused by viruses or bacteria, etc. Commonly used in the treatment of the prostate are Pulsatilla tablets and compound Mekasa tablets. Due to the complex pathogenesis of prostatitis, Chinese herbal medicine is also unique in the treatment of prostatitis and can be used for dialectical treatment. The actual fact is that you can find a lot of people who are not able to get a lot of money to spend on their own. The actual fact is that it is a very good idea to have a good deal more than just a few of the same things. Important triggers for the development of prostatitis include: excessive alcohol consumption, spicy food, inappropriate sexual life (excessive or none), sedentary, cold, fatigue, etc. leading to a decrease in body resistance. These aspects can be prevented. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The next thing we’ll talk about is another common prostate disease: prostate enlargement. This kind of disease is more common among the elderly. The actual fact is that it is a kind of disease, and what kind of harm will it do to the human body? Prostate hyperplasia is caused by the enlarged prostate gland pressing on the urethra, resulting in a series of symptoms related to urination. For example, difficulty in urination, incomplete urination, dripping urine, weakness in urination, but also frequent nighttime urination, frequent urination, urgent urination, painful urination, etc., which seriously affects the patient’s quality of life. Especially frequent nocturnal urination, poor rest, easy to induce cardiovascular disease, urinary urgency, can lead to accidents, falls and fractures, etc. As the familiar saying goes: running water does not rot, the household pivot is not worm-eaten, poor urination, a large amount of urine remains in the bladder, leading to infection and easy to form stones. Our life experience is: bathroom, the second floor blockage, the second floor back, a large amount of long-term residual urine in the bladder can lead to urine reflux down the ureter to the kidneys, leading to hydronephrosis, which can seriously lead to kidney failure, is often said to be uremic syndrome. Holding urine can hold a fart, some elderly people have difficulty urinating, the abdominal pressure increases, coupled with the weak abdominal wall, easy to hold a hernia to. Some patients are suddenly unable to discharge urine, medically known as: urinary retention, requiring emergency catheterization treatment. These are the common symptoms and hazards of prostate hyperplasia, which vary in performance and severity for different people. The host: If prostate hyperplasia is a common disease among the elderly, then the elderly are generally afraid to go to the hospital for tedious tests. If you want to confirm the diagnosis for them, are there some advanced and simple tests available now? Director Gong: Men over the age of 50 with urination-related symptoms should first consider the possibility of prostate hyperplasia. Besides taking a medical history and physical examination, there are not many labs and tests needed. The most commonly used are urine routine, ultrasound and prostate-specific antigen. The most common tests are routine urine examination, ultrasound and prostate specific antigen. Prostate-specific antigen is a laboratory test to rule out the presence of prostate cancer, which, in most cases, is elevated. Urination is a complex physiological phenomenon that is also influenced by many factors such as nerves. For example, if the faucet is turned on and there is still no water, there may be insufficient water pressure. The water pressure here refers to the contraction force of the bladder. Diseases that may affect the contraction force of the bladder include diabetes, cerebrovascular disease, Parkinson’s, and spinal trauma. Some people have their prostate removed only to find out that there is a problem with bladder function as well, and that can be a problem. Complicated cases may require complex tests. Our hospital has the relevant urodynamic testing facilities and an experienced treatment team that can detect and manage these complications before surgery. Here, by the way, we would like to mention the treatment routine to facilitate better understanding between doctors and patients. The initial onset of frequent and painful urination, with a clear cause and reason, is most likely to be a urinary tract infection, and may be unchecked or simply checked, while some doctors may consider rare or serious diseases and perform complex or expensive tests. The diagnosis should be further considered in addition to adjusting the treatment measures if the treatment is not effective or if the condition worsens. The treatment routine first considers common and multiple diseases. Doctors should inform them of the risks and let patients decide whether to have simple or complex investigations. Some people, who have all the time in the world, ask for a step-by-step, slow check; others, who have all the money in the world, ask for a step-by-step, rapid check. Patients should also explain their intentions when they visit the clinic. Doctors can take different treatment measures depending on the situation. Vigilance waiting, medication, surgery. Those with mild symptoms and no complications can be treated with vigilant waiting, which means close monitoring. If the symptoms are severe, medication can be used: there are two main types of drugs: alpha-blockers, as mentioned, and 5 alpha reductase inhibitors, commonly finasteride, dutasteride, etc. Alpha-blockers can reduce urethral resistance and improve symptoms; 5 alpha reductase inhibitors can reduce the size of the prostate to some extent. When medication is poor, complications arise, and surgery is indicated, surgery can be considered. Moderator: Many patients have tension and anxiety in the process of treatment, and they try to favor conservative therapy or medication in the choice of treatment. How do you choose the many medications? Do you need to pay extra attention to any problems if you take medication? Director Gong: The choice of medication is also preferred if it is suitable for medication. There are often patients who ask which of the many medications for prostate enlargement, this pungent, that zin, this non, that degree, which is better? The actual fact is that you can find a lot of people who are not able to get a good deal on this kind of things. The first of these is to make sure that the patient’s head is not too far away. The host: There are also some patients suffering from prostate enlargement, due to the seriousness of the disease rely on drugs has little effect, then perhaps surgery will be a new option. The actual fact is that you can find a lot of people who are not able to get a lot of money from the internet. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. Generally, surgical treatment can be considered when the following conditions occur: 1) recurrent urinary retention 2) recurrent hematuria 3) recurrent urinary tract infections 4) bladder stones, inguinal hernia, hydronephrosis, renal insufficiency, etc. Please note that many complications, which use the word recurrent, can be considered for systemic medication if they occur without systemic treatment. Moderator: Many patients are very afraid when they hear about surgery, and everyone is afraid of being operated. But modern medical technology is highly developed, and minimally invasive surgery has alleviated the pain of many patients. The actual fact is that you can find a lot of people who are not able to get a lot of money. The way there are electrodes, vaporization, laser. The lasers are: holmium laser, green laser, 2 micron laser, etc. Patients often ask: which is better? The equipment has its own advantages and disadvantages and is a tool for doctors to treat the disease and achieve the fundamental purpose of removing the prostate. This is just like going to Beijing, you can take a train, you can take a plane, or you can drive yourself. The actual fact is that you will be able to get a lot more than just a few of these! Moderator: We always say that no disease should be taken lightly, because the changes of the disease are very subtle. Some diseases may develop into what you least expect to face: malignancy. So what kind of disease is prostate cancer? Is prostate cancer common? Is it highly malignant? Director Gong: Prostate cancer is the most common malignant tumor in men in western countries, probably related to ethnicity and dietary habits. The incidence of prostate cancer in China has been increasing in recent years. The symptoms are similar to those of prostate hyperplasia. Bone pain can occur in advanced metastasis. The diagnosis of prostate cancer is mainly based on: rectal examination, prostate-specific antigen (PSA) and transrectal prostate ultrasound. the normal value of PSA is less than 4ng/ml. the above tests, especially when PSA is abnormal (the standard varies in different countries), should be performed when it meets the indication of prostate puncture biopsy to determine whether it is prostate cancer. Generally speaking, the higher the PSA, the greater the likelihood of cancer. Prostate cancer is a malignant tumor and may require several tests such as MRI, whole body bone scan, liver, gallbladder and spleen ultrasound to assess the condition and whether there is metastasis, etc. It is meaningful for the choice of treatment and the related tests need to be repeated during the treatment process to assess the treatment effect. Some tests are to determine the diagnosis, some are to exclude suspicion, some are to assess the severity, some are for disease typing, some are to assess the effectiveness of treatment, and some are requested by the patient. So some tests may have normal results and some tests need to be repeated. Overall, prostate cancer is a relatively less malignant cancer compared to liver cancer, lung cancer, breast cancer, etc. Some patients are still alive after 10 years, and the 3-year survival rate can reach more than 50%, which means that 50 patients are still alive after three years. Some elderly people die from cardiovascular disease, not prostate cancer. The first thing you need to do is to make sure that you have a good idea of what you are doing. The actual fact is that there is not enough medical research evidence to show a relationship between prostatitis and prostate enlargement and prostate cancer. It is generally believed that prostate enlargement and prostate cancer are two relatively independent diseases, and that prostate enlargement does not turn into cancer. The main reason for this is that it is a very important part of the process. The actual fact is that it is not a good idea to have a good time. Are there any good treatments available? Director Gong: The incidence of prostate cancer has been increasing in China in recent years, and the statistics in 2000 showed that there were 5 cases per 100,000 men. The treatment of prostate cancer includes: wait-and-see, radiation therapy, endocrine therapy and surgery. The choice of treatment includes whether the tumor is advanced or early, the patient’s age, the expected number of years to live, and the level of malignancy of the tumor. Patients in the middle and late stages can be treated with endocrine therapy and radiotherapy, while early stage patients can be treated with radical surgery, which can be laparoscopic surgery with less trauma, less bleeding, faster recovery and higher quality of life. Moderator: Nowadays, more and more people are doing health check-ups, ultrasound examinations, often with such reports: what does calcification or stones in the prostate mean? The prostate is slightly enlarged? How to deal with it? Director Gong: Diagnosis of the disease should be combined with symptoms and laboratory test results, not simply from a result, to make an arbitrary diagnosis. There are many ducts within the prostate, and urine reflux can form small stones or calcified foci within it, just like urine alkali may appear when the urinal is used for a longer period of time, without symptoms and evidence of prostatitis, which does not require treatment. The normal prostate 2*3*4 cm, just like someone who is tall, short, fat or thin, some people may be slightly larger, no symptoms, especially young people, can not be diagnosed with prostate hyperplasia. The actual fact is that you can find a lot of people who are not able to get a good deal on this. The actual fact is that you can find a lot of people who are not able to get a good deal on this. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. 1, quit smoking 2, avoid alcoholism 3, avoid uncontrolled eating spicy food 4, regular sexual life (avoid excessive or none) 5, avoid sedentary 6, drink an appropriate amount of water, do not hold urine. 7, reduce animal fat intake 8, eat tomatoes, drink more green tea, sunshine. 9.Avoid prolonged cycling.