Prostate enlargement
The symptoms of prostate enlargement are mainly two groups of symptoms, one is bladder irritation symptoms; the other is obstructive symptoms due to blockage of the urinary tract by the enlarged prostate.
The first one is the bladder irritation symptoms: urinary frequency, urinary urgency, increased nocturia and urge incontinence. The frequency of urination is an early sign of prostate enlargement, especially the increase in the number of nocturnal urination is more clinically significant. In general, the number of nocturnal urinations often parallels the degree of prostate enlargement. The presence of 1 to 2 nocturnal urinations in the elderly who originally did not get up at night often reflects the onset of early obstruction, while the development from 2 times per night to 4 to 5 times per night or even more indicates the development and aggravation of the lesion. Li Xingzhi, Department of Urology, People’s Hospital of Inner Mongolia Autonomous Region
2, urinary obstruction symptoms: mainly due to prostate enlargement blocking the urinary tract.
(1) weakness of urination, thinning of the urine line and dripping of urine: due to the obstruction of the enlarged prostate, patients have to use more force to overcome the resistance to urination, so that it is difficult to urinate; the enlarged prostate deflates the urethra resulting in a thin urine line; with the development of the disease, there may also be interruption of urination, dripping after urination and other symptoms.
(2) Hematuria: Blood in urine is hematuria, also known as blood in urine. Under normal circumstances, there are no red blood cells in urine. Medically, when the patient’s urine is centrifuged and precipitated and examined with a microscope, if there are more than 5 red blood cells in each high magnification field, it is called hematuria.
(3) Urinary retention: In advanced patients with more severe prostate enlargement, acute urinary retention can occur when the obstruction is severe due to cold, alcohol, holding urine for too long or infection, etc. Urine cannot be discharged.
(4) Frequent urination is an early sign of prostate enlargement, especially the increase in the number of nocturnal urination is more clinically significant. In general, the number of nocturnal urination tends to parallel the degree of prostate enlargement. The original elderly who do not get up at night appear to urinate 1 to 2 times at night, often reflecting the onset of early obstruction, while the development from 2 times per night to 4 to 5 times per night or even more, indicates the development and aggravation of the lesion.
Clinical manifestations of prostate enlargement
Prostate
Signs of early prostate enlargement
The symptoms of prostate enlargement can be divided into two categories, one is the obstructive symptoms arising from the blockage of the urinary tract by the enlarged prostate; the other is the complications caused by the obstruction of the urinary tract.
1, obstructive symptoms are mainly caused by the prostate enlargement blocking the urinary tract and compressing the bladder neck, and also include the reaction of the bladder itself to overcome the obstruction.
The first thing you need to do is to get a good idea of what you are getting into. In general, the number of nocturnal urinations often parallels the degree of prostate enlargement. The presence of 1 to 2 nocturnal urinations in elderly people who originally did not get up at night often reflects the onset of early obstruction, while the development from 2 times per night to 4 to 5 times per night or even more indicates the development and aggravation of the lesion.
② Weakness of urination, thinning of the urine line and dribbling of urine. Due to the obstruction of the enlarged prostate, the patient has to use more force to overcome the resistance to urination, so that it is difficult to urinate; the enlarged prostate deflates the urethra, resulting in a thin urinary line; as the disease progresses, there may also be symptoms such as interruption of urination and dripping after urination.
③Hematuria.
④Urinary retention. In advanced patients with heavy prostatic hyperplasia, acute urinary retention may occur due to cold, alcohol, prolonged urine holding or infection, etc. when the obstruction is severe.
2, the complications of obstruction are mainly infection, hydronephrosis, uremia, etc.
Prostate enlargement
①Infection Just as an unobstructed river is prone to pollution, the urinary tract with an obstructed bladder neck is very prone to combined acute urinary tract infections, showing a sudden increase in the number of nighttime urination, urinary urgency, painful urination, hematuria, and fever.
When the water accumulation is serious, you can feel a “lump” – a distended kidney – in the abdomen; when the bladder is full, you can also feel a “lump” – a distended kidney – in the lower abdomen. When the bladder is full, you can also feel a “lump” in the lower abdomen – a distended bladder.
③Uremia Patients with prostatic hyperplasia that develop into hydronephrosis can suffer from renal insufficiency – uremia – due to pressure on the kidney parenchyma. It manifests as loss of appetite, nausea, vomiting, and anemia. Because such symptoms are relatively insidious at first and lack specificity, they are easily overlooked or misdiagnosed as gastrointestinal diseases and delayed, or even not discovered until headache, sluggishness, drowsiness, or even coma occurs, which is worth being alert to.
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In addition, because of the prostate enlargement causes patients to urinate because of the difficulty, the abdominal pressure increases, but also can cause or aggravate hemorrhoids, hernia and other diseases.
The clinical characteristics of the onset of prostate hyperplasia in young adults.
1, easily misdiagnosed as chronic prostatitis.
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The actual fact is that you can find a lot of people who are not able to get a good deal on this. The majority of young adults urinate at night within 2 times.
Examination items of prostate enlargement
The prostate enlargement patients are often combined with other chronic diseases due to their age, so some necessary laboratory tests are also done.
1. urinalysis The routine urinalysis of patients with prostatic hyperplasia can sometimes be normal, but now when the urinary tract infection is visible red, white blood cells, protein urine, pus urine and alkaline urine. The presence or absence of hematuria, urine sugar and bilirubin can also be determined through the examination. Urine smears are microscopically examined and cultured to bacteria. When collecting urine, it must be done before the rectal finger examination to avoid prostate; ringing the examination results.
2. blood Routine blood and biochemical tests are important for those with infections and uremia caused by obstruction. The degree of uremia is reflected in the degree of reduction of hemoglobin. In the case of urinary tract infection, the blood leukocyte count and classification are also of reference value for diagnosis and treatment.
3. kidney function measurement Prostate hyperplasia patients can choose the following items for examination according to their specific conditions.
(1) blood urea nitrogen, creatinine measurement
(2) Phenol red excretion test.
(3) Indocyanine excretion test.
(4) Urine concentration and dilution test.
(5) General or high-dose intravenous urography.
(4) Measurement of serum prostate specific antigen (PSA) to rule out the possibility of prostate cancer. It is important to note that in some cases PSA can be falsely positive, i.e. in the following cases, such as recent ejaculation, inflammation, ischemia or infarction of the prostate, benign prostatic hyperplasia and malignant prostate cancer. There are new methods for measuring free and bound PSA, which can improve the accuracy of differentiating prostate hyperplasia from prostate cancer.
The urine flow rate can indirectly measure the function of the lower urinary tract from the change in urine flow rate, which is very helpful in determining the lesion. Therefore, the urine flow rate can be measured at the initial diagnosis, during and after treatment to determine the efficacy of the treatment. Based on the non-invasive nature and clinical value of this test, it should be measured before, during, and after treatment where available.
The residual urine is not more than 10ml in normal people, but in patients with prostatic hyperplasia, the amount of residual urine can increase. Measuring the amount of residual urine can help determine the degree of prostatic hyperplasia and is one of the indicators for considering whether to perform surgical treatment, so measuring residual urine is an important diagnostic step. It is recommended that the residual urine after urination should be measured during the initial evaluation of the patient and after treatment to determine efficacy. A simple and non-invasive way to do this is by transabdominal ultrasound. Since the amount of residual urine in a person fluctuates widely, the initial examination should be repeated once for accuracy if there is a large amount of residual urine.
7. Zinc measurement The plasma zinc level is significantly higher in the case of prostate enlargement. It can be used as one of the indicators to diagnose prostate enlargement.
This is a common disease in older men. Also known as benign prostatic hyperplasia, prostate hypertrophy. The actual prostate gland is not enlarged, but rather enlarged. The actual name has been used for many years, and is often used clinically. The autopsy at home and abroad have shown that more than half of men over 60 years of age can be found with histological enlargement of the prostate, but 1/4 of them have an enlarged prostate visible to the naked eye, half of which may require treatment. The mechanism by which prostatic hyperplasia occurs is not fully understood.
The main clinical manifestation is abnormal urination. The symptoms can be divided into two categories: obstruction and irritation; obstruction symptoms are hesitation, intermittence, terminal dribbling, thin and weak urine line, and incomplete urination. Irritation symptoms are frequent urination, nocturia, urgency and painful urination. Symptoms can be aggravated by cold, alcohol consumption and the application of anticholinergics and psychiatric drugs. Long-term obstruction can lead to symptoms of uremia such as weakness, drowsiness, nausea and vomiting.
The prostate gland may be enlarged and the median sulcus may disappear or bulge, and the presence of hard nodules and prostate cancer should be noted. Uroflow rate examination can help to understand the degree of urinary obstruction. It should also be differentiated from urethral stricture and neurogenic bladder dysfunction. Neuropathy is associated with relaxation of the anal sphincter and other neuropathic symptoms during rectal palpation.
Rectal Finger Diagnosis of Prostatic Hyperplasia
The normal prostate is about the size of a chestnut (weighing about 20g) and can increase in size by 2 to 4 times in this disease. The majority of cases are grayish-white nodular (a few are diffuse), with small sieve-like cavities forming on the cut surface and a milky discharge spilling out of the well towards the cut surface. In the prostate removal specimen, the hyperplastic nodules are seen to be compressed in the inner and outer regions and have an envelope-like appearance. This “surgical envelope” makes surgical removal easy to perform. The hardness of the nodules depends on their hyperplastic composition. The softness of the nodules is mainly in the form of glandular hyperplasia, while the hardness of the nodules is in the form of fibrous tissue or smooth muscle hyperplasia. It is common for hyperplastic nodules to compress the urethra.