The prostate is one of the male accessory sex glands, normally as large as a chestnut, about 20-25 grams, it is located in the neck of the bladder (both below the bladder in the standing position) and wraps tightly around the posterior urethra below the bladder outlet, in adolescents, its function is mainly to secrete the fluid that makes up part of the semen. The three most common types of prostate disorders are: prostatitis, prostate hypertrophy and prostate cancer. Here we talk about the most common prostate lesion, prostatic hyperplasia. In men, after the age of 40, the prostate starts to grow. After about 50 years of age, the enlarged prostate gland exerts pressure on the urethra and symptoms such as frequent and urgent urination occur. The androgens produced by the male testes and the increased age are two important conditions for prostate enlargement. The Chinese medicine believes that this disease belongs to the category of “retention of urine”, which is due to the weakness of the kidneys and the inability of the qi to be transformed into the Zhoudu (bladder), so the urine is unfavorable. In men, the incidence is 50% over the age of 55, 90% over the age of 80, and 100% over the age of 90 with histological changes of prostate hyperplasia. The etiology of prostatic hyperplasia is still unclear. Studies have found that dihydrotestosterone, a metabolite of androgens, is significantly higher in hyperplastic prostate tissue. Studies have shown that the main form of action of androgens is the conversion of testosterone to dihydrotestosterone through 5-alpha reductase, which then acts in the prostate. In addition, the imbalance of estrogen and androgen regulation, certain growth factors, and apoptosis affect the proliferation of prostate cells, and these studies provide the basis for the prevention and treatment of prostate enlargement. This condition is common in older men, and if treated promptly in the early stages of hyperplasia, no serious complications will occur. Prostate enlargement leads to long-term obstruction of the bladder neck opening, which further leads to impaired function of the bladder forcing muscle. When the function of storing and excreting urine is severely impaired, treatment often fails to achieve the desired results. This is because the prostate gland has increased to a certain extent and has squeezed the posterior urethra through its center, making the posterior urethra thinner and more curved, forming a section of the “canyon”, the lighter the effort to urinate, the thinning of the urine stream, the frequency of urination during the day, the night In the lighter cases, the urinary effort, thin urine flow, frequent urination during the day and more frequent urination at night, and in the heavier cases, waiting for urination, difficulty in urination, prolonged urination, thin urine line, weak urination, segmental urination, etc., and even incomplete dripping, are embarrassing and affect work and life. In addition to the above, sometimes suddenly a drop of urine can not come out, the medical term is acute urinary retention, at this time, you have to go to the hospital to see the urological emergency, often need to insert a catheter (catheterization) to retain the urine in the bladder to lead out to solve the urgent problem. Once this happens, the patient suffers from the pain of “living people suffocating in urine”. When catheterizing, be careful not to drain a large amount of urine at once to avoid causing hypotension or hematuria. Long-term difficulty in urination can lead to ureteral effusion, hydronephrosis or other complications such as hernia (inguinal hernia), hemorrhoids, etc., and eventually uremia. If some of the above symptoms occur, the easiest way to know if you have an enlarged prostate is to touch the prostate with your finger through the rectum (rectal finger test), which is normally the size of a chestnut. If there are hard nodules, it should be taken seriously and differentiated from prostate cancer by further transrectal prostate ultrasound and blood PSA (prostate-specific antigen) examination. Other tests such as ultrasound of kidney, ureter and bladder, residual urine measurement, urodynamic examination and cystoscopy if necessary are very helpful in making a clear diagnosis, understanding the function of the urinary tract and developing and selecting a treatment plan. There are three main aspects of treatment for this disease: vigilant observation, medication and surgery. An experienced physician will make an assessment based on the patient’s signs and symptoms, the presence of complications, and the patient’s overall condition, and give the patient an IPSS score (International Prostate Screening Symptom Score): an IPSS score of less than 7 indicates mild symptoms, and if there are no complications or high risk or advanced age, the patient can usually be placed under vigilant observation. For moderately symptomatic prostate enlargement, medication is used first. There are three main types of drugs with more certain efficacy: first, 5α reductase inhibitors, which can inhibit prostate enlargement by preventing the conversion of testosterone into active dihydrotestosterone, thus achieving a therapeutic effect. The second is alpha blockers, which make urination less difficult by reducing tension in the bladder neck and posterior urethra. Thirdly, plant-based preparations: such as sernitone and some herbal preparations for the treatment of prostate enlargement, also have some effect. For patients with more serious symptoms, a combination of these drugs is often required in order to achieve efficacy as soon as possible. For those who have severe urinary difficulties, have developed complications, and whose symptoms have gradually worsened after ineffective drug treatment, surgical treatment is often required. The traditional open surgical removal of the prostate is now used sparingly. Transurethral resection or enucleation of the prostate is now the main treatment, and these procedures include electrodesection, vaporization and plasma cutting of the prostate, holmium laser enucleation of the prostate, etc. Some patients are in poor health and suffer from entrapment such as cardiovascular disease, and when they are temporarily unable to tolerate surgery, they can undergo aggressive treatment in internal medicine to Improving the patient’s physical condition and then performing holmium laser prostate enucleation is an opportunity for some patients who cannot tolerate surgery to obtain surgical treatment and resume urinating on their own.