Treatment of prostatic hyperplasia

  Prostatic hyperplasia does not require treatment if there are no symptoms of urinary tract obstruction and renal dysfunction, but should be treated if it affects urination and normal life.  The actual fact is that you can find a lot of people who can’t tolerate surgery because they are old and frail.  1, hormone therapy: estrogen can make the prostate gland shrink, improve urinary symptoms, but after stopping the drug can relapse. The actual fact is that you can find a lot of people who have been in the marketplace for a long time. It is also possible to use haloestradiol 4 mg, intramuscularly, once daily, benz estradiol 1-2 mg, intramuscularly, once daily, or progesterone 20 mg, intramuscularly, once daily.  2, alpha-adrenergic receptor blocker treatment: there are a large number of alpha-adrenergic receptors within the prostate peritoneum and bladder neck. This receptor excitement can lead to bladder neck contraction and aggravate the symptoms of urinary tract obstruction. Therefore, the clinical application of alpha-adrenergic receptor blockers for the treatment of early prostatic hyperplasia is satisfactory, and commonly used are dextran, tetrabenazine, prazosin, benzylamine, etc.  3, 5-alpha reductase inhibitors: inhibit testosterone into dihydrotestosterone to make the prostate shrink and shrink. It does not affect sexual function. It is the most ideal drug for the treatment of prostate enlargement, only the application time is long, need to take more than three months orally. The commonly used is Paulownia.  4, injection therapy: the drug is injected directly into the prostate, so that the prostate tissue undergoes aseptic necrosis, liquefied absorption and the prostate shrinks. The effect of this method is unstable, the recurrence rate is high, and it is easy to cause perineal pain, so it is not easy to promote.    1, prostate removal: prostate removal is the radical treatment of prostatic hyperplasia, suitable for patients with obvious urinary tract obstruction, good general condition and no serious impairment of heart, lung, liver and kidney function. The actual fact that this disease occurs in elderly patients, the preoperative preparation is extremely important, such as the examination and treatment of cardiopulmonary, hepatic and renal functions, drainage of residual urine and control of urinary tract infection. The surgical route for prostate removal is transurethral, suprapubic, retropubic and perineal. The first two are more commonly used, and suprapubic transcatheter prostate removal is easy for general surgeons to master, with good exposure and complete removal of the hyperplastic tissue, and other lesions in the bladder can be treated at the same time, such as stones and tumors. However, this method is very damaging, prostate bleeding is not easily controlled completely, and the recovery period is long.  In recent years, with the advancement of equipment and technology, the use of transurethral resection of the prostate has become increasingly widespread. This method has the advantages of less pain, less damage and faster recovery, but it is technically difficult, not easy to master and more expensive. Now the clinic has been widely carried out.   This method is simple and easy to perform, does not require special equipment, and is less dangerous.  The actual cystostomy: mostly for the old and frail and those who can not take care of themselves, because of the inconvenience of life is now rarely used.   This method requires special instruments and freezing agents. The most commonly used freezing agent is liquid nitrogen, and the instruments include vacuum insulated containers for preserving liquid nitrogen and insulated pipes and urethral probes for transporting liquid nitrogen to the urethra. The efficiency of this method is reported to be 94% in China. However, the depth and breadth of freezing is not easy to grasp, and there are complications such as bleeding, urinary incontinence and rectal fistula.  The microwave and radiofrequency treatment The bio-thermal effect of microwave and radiofrequency plays a role in thermal coagulation of the tissue. The hyperplastic prostate gland is coagulated and necrosis occurs after the action of microwave and radiofrequency waves to achieve the purpose of treatment. This method requires special treatment machines and other special equipment. The treatment of the prostate is a very important part of the process. The long-term efficacy is not sure, and it is rarely used now.     It is now rarely used.  The application of nickel-titanium shape memory alloy stent tube The application of nickel-titanium shape memory alloy stent is to use its shape memory recovery after deformation to produce a continuous, gentle expansion of the urethra of the prostate to support the patient to urinate, with the advantages of easy operation, less pain, less injury, low cost and quick recovery and avoid cystostomy. However, the long-term results are not good.