What is Benign Prostatic Hyperplasia (BPH)? Benign prostatic hyperplasia (BPH) is one of the most common benign diseases that cause urinary disturbances in middle-aged and older men, mostly in men over 50 years of age. The main manifestations are histological enlargement of the interstitial and glandular components of the prostate, anatomical enlargement of the prostate (benign prostatic enlargement, BPE), urodynamic obstruction of the bladder outlet (BOO), lower urinary tract symptoms (LUTS). symptoms (LUTS) are the main clinical symptoms, lower urinary tract symptoms include bladder irritation symptoms and obstruction symptoms. Prostatic hyperplasia can be divided into histological prostatic hyperplasia and clinical prostatic hyperplasia. Histological prostatic hyperplasia is determined by autopsy and can be manifested as an obvious increase in prostate volume or only as a microscopic microscopic hyperplasia with or without clinical symptoms. The clinical prostate enlargement should include: the presence of objective evidence of prostate enlargement; the presence of lower urinary tract symptoms; and the presence of bladder outlet obstruction. The incidence of histological prostatic hyperplasia increases gradually with age and usually occurs initially after the age of 40. The incidence of prostate enlargement in the age group of 60-69 years is about 70%, in the age group of 70-79 years is about 80%, and in the age group of 80 years and above is about 90% or more. The incidence of histological prostatic hyperplasia was also summarized for eight different countries, including China, and it was found that the incidence of histological prostatic hyperplasia did not differ by race or geography, and all increased with age. To date, the exact mechanism by which BPH occurs is unknown and may be caused by a balanced disruption of the proliferation of epidermal and mesenchymal cells and apoptotic cell death. In general, the factors leading to prostatic hyperplasia can be divided into intrinsic and extrinsic factors, the former mainly including mesenchymal-epithelial cell interactions and the latter including androgens, estrogens, growth factors, neurotransmitters, environment and genetics, which either individually or in interaction, ultimately lead to BPH. Domestic scholars have investigated 26 elderly eunuchs of the Qing Dynasty and found that the prostate glands of 21 people had become completely inaccessible or significantly atrophied. Therefore, the global medical community now unanimously recognizes that old age and functioning testes are two important conditions for the occurrence of BPH, one without the other. The basic activity of normal urination is the coordination of both bladder forcing muscle contraction and urethral resistance. When the periurethral glands protrude into the urethra, they bend, lengthen, and narrow the urethra of the prostate segment and increase urethral resistance. The bladder forceps must contract excessively to allow the voiding process to be initiated and completed, resulting in compensatory hypertrophy of the forceps. The bladder triangle is the most sensitive area of the bladder and the site where compensatory hypertrophy occurs first, so a very small amount of urine can stimulate the triangle and make a person feel the urge to urinate, and the number of urination starts to increase, most obviously at night, called nocturia, which is the earliest symptom of lower urinary tract obstruction, and the reason why there is nocturia and the number of urination during the day is not yet high is because the person is distracted during the day and the threshold of the sense of urination is increased. If inflammation occurs in the bladder mucosa or if there is residual urine, there will be frequent urination, and in severe cases, there will be an urge to urinate every 15-30 minutes, and when the bladder neck and triangle are inflamed, there will also be a sense of urgency, and urine will drip out before the person can urinate on his own. The resistance of the urethra increases and the bladder muscles have to contract excessively in order to start urination, resulting in a delayed onset of urination. This is particularly noticeable in the morning during the first urination. The incomplete contraction of the hypertrophied forceps combined with the increased urethral resistance makes the urine line weak, and the contraction at this time is no longer able to empty the urine, and after the first contraction, a second weaker contraction occurs to empty the bladder, at which time no urine line is formed, resulting in a start-stop-start interruption of the urine line, which is also the cause of terminal dripping of urine. Residual urine occurs when the enlarged prostate gland exerts progressive pressure on the bladder outlet and the bladder forceps cannot empty the urine completely even with excessive contraction. The residual urine is a good breeding ground for bacteria, and with the impaired defense mechanism of the bladder mucosa, it can easily lead to urinary tract infections. The patient may experience acute urinary retention after sympathetic excitement caused by cold, drinking alcohol, holding back urine or other reasons. The human prostate capsule and smooth muscle are rich in alpha adrenergic receptors, and the alpha receptors are stimulated to increase the contraction and tension of the gland. Therefore, in addition to the mechanical component of adenoma compression, there is also a dynamic component of increased contraction and tension of the glandular capsule and muscle tissue. The mechanical component develops gradually, while the dynamic component responds differently depending on the presence or absence and strength of sympathetic stimuli, so the patient’s urinary state can be good or bad, which is an important theoretical basis for the occurrence of acute urinary retention. The kidney insufficiency is the end result of prostate enlargement causing lower urinary tract obstruction without reasonable treatment. A few patients are unaware of the abnormal urinary symptoms or think it is an inevitable change with old age and do not care, but the lesion is developing insidiously and eventually uremia develops (loss of appetite; anemia; elevated blood pressure; dullness of consciousness; drowsiness to coma). The lower abdominal mass with a full bladder; the upper abdominal mass with hydronephrosis; and increased abdominal pressure during prolonged urination will eventually cause hemorrhoids, prolapse, and hernia formation. The analysis of the efficacy of BPH patients before and after treatment requires quantitative indicators. The International Prostate Symptom Score (I-PSS) is currently the best internationally recognized means of determining the severity of lower urinary tract symptoms in BPH patients. Based on the results of the I-PSS score, patients can be classified into the following three categories: 0-7 as mild lower urinary tract symptoms; 8-19 as moderate lower urinary tract symptoms; and 20-35 as severe lower urinary tract symptoms. Rectal palpation can reveal the size, shape, texture, presence of nodules and pressure pain of the prostate, whether the central sulcus becomes shallow or disappears, and the tension of the anal sphincter. Ultrasound can describe the shape and volume of the prostate more accurately. Prostate volume = product of three diameters x 0.52 and prostate weight = volume x 1.05.