Prostate enlargement: is a common disease in older men, its clinical manifestations have symptoms mainly manifested as two groups of symptoms, one is bladder irritation symptoms; the other is obstructive symptoms arising from the blockage of the urinary tract by the enlarged prostate.
1, 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 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 4~5 times per night or even more, indicates the development and aggravation of the lesion.
2. Urinary obstruction symptoms.
It is mainly due to prostatic hyperplasia obstructing the urinary tract.
Its main manifestations are.
(1) weakness of urination, thinning of the urine line and urine dripping: 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 will deflate the urethra to thin the 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, after 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 nocturnal elderly 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 4~5 times per night or even more, indicates the development and aggravation of the lesion.
The so-called hyperplasia refers to the increase in size of tissues and organs due to the increase in the number of parenchymal cells, which is the result of enhanced mitotic activity of cells caused by various reasons. The prostate gland is no exception, from birth to adolescence, the development of the prostate gland, growth is slow; after adolescence, the growth rate accelerated to about 24 years of age to the peak of development, 30 to 45 years of age between its volume is more balanced, after some people tend to atrophy, the gland volume becomes smaller;
The other part can tend to be hyperplastic, the volume of the gland gradually increases, if obviously compressing the urethra of the prostate, can cause bladder outlet obstruction and urinary difficulties related symptoms, namely prostate hyperplasia. This is a good way to get the most out of your life. The prostate hyperplasia is a common disease in older men, and the pathological changes of hyperplasia generally begin to occur after the age of 40, and the symptoms associated with it appear after the age of 50.
The prostate hyperplasia patients are often combined with other chronic illnesses 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, and now urinary tract infections can be seen in red, white blood cells, proteinuria, pus urine and alkaline urine. The examination can also determine the presence of hematuria, urine sugar, bilirubin. 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 Blood routine and biochemical examination, is very important for those with infections caused by obstruction, uremia, 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 Prostatic hyperplasia patients can choose the following items for examination according to their specific circumstances
(1) blood urea nitrogen, creatinine measurement
(2) urine concentration, dilution test.
(3) Anal diagnosis, ultrasound examination.
(4) 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 false 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 between prostate hyperplasia and prostate cancer.
The urine flow rate test can indirectly measure the function of the lower urinary tract from the changes in the 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 in places where it is available.
6. Residual urine measurement The residual urine in normal people is no more than 10 m1, while patients with prostatic hyperplasia can have an increase in the amount of residual urine, so the measurement of residual urine is one of the important diagnostic steps. 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 detect 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.
Key points in the diagnosis of prostatic hyperplasia
1, mostly seen in older men over 50 years old. Early manifestations are frequent urination, increased nocturia, difficulty in urination, and weak urine flow. In the late stage, there can be severe urinary frequency, urinary urgency, difficulty in urination, or even spotting, small abdominal distension, and a full bladder can be palpated.
2, rectal finger diagnosis: prostate enlargement, hard texture, smooth surface, central groove disappears.
3, B-type ultrasound examination, can show the enlarged prostate. Cystoscopy, excretory urography, etc., are helpful in diagnosing this disease.
4. This disease should be differentiated from gonorrhea, guanger, urethral stricture, prostate cancer, prostate sarcoma, prostate stones, and neurogenic bladder dysfunction.