Benign prostatic hyperplasia
1.Overview
If a man is over 50 years old, he cannot tolerate frequent and urgent urination if he urinates more often at night, has a weak urine stream, and wets his underwear.
Only men have a prostate gland, weighing about 20 grams, the size of a walnut, located below the bladder and wrapping around the proximal urethra that connects to the bladder.
It is a common condition in men over the age of 50 and is associated with an excess of an androgen called dihydrotestosterone.
Although it is not a major life-threatening condition, it can significantly affect the patient’s physical activity and ability to socialize, thus seriously affecting his quality of life.
Age-related volume of the prostate.
BPH is not an infectious disease.
there is also no evidence of a genetic link.
the effect of food on the disease is also inconclusive
approximately 50% of men over 50 years of age have BPH
80% to 100% of those over 80 years of age have the disease
In China, statistics from 1921-1935 (Peking Union Medical College Hospital), BPH accounted for only 6.6% of men over 41 years of age; however, the incidence has increased dramatically over the decades
According to a 1993 statistic from Shanghai: approximately 45.6% of men over the age of 50 had an enlarged prostate
Benign prostatic hyperplasia is one of the most common diseases in urology.
Benign prostatic hyperplasia is not cancer and does not transform into cancer. BPH in the prostate grows slowly and does not spread to other parts of the body
(Inflammation of the prostate, which can be classified as acute or chronic. The main symptoms include pain during urination, increased frequency of urination, etc. The acute stage can cause fever.
In the early stage of prostate cancer, there are no special symptoms, but when the cancer grows, it will squeeze the urethra and cause difficulty in urination.)
2.Benign prostatic hyperplasia symptoms
Beginning.
1, frequent urination, increased frequency of urination
2. Frequent nocturnal urination
3.Urgent urination, unable to hold urine
4.Incomplete urination (feeling of incomplete urination)
5.Delayed start of urination
6.Intermittent urination and weak urine flow
7.Painful urination
8.Urinary incontinence
After that may.
1.Acute urinary retention
2.Urinary tract infection
3.Bladder stone
4, hydronephrosis
5.Renal failure
The doctor may recommend the following tests.
1, rectal finger examination
It can determine whether there is prostate enlargement
2. Serum prostate-specific antigen (PSA)
is a new diagnostic tool for the evaluation and management of BPH and is also an indicator for the diagnosis of prostate cancer
3. Transabdominal or transrectal ultrasound of the prostate
It can determine the size of the prostate volume
4. The overall score range is 0-35 (asymptomatic – very severe symptoms)
International Prostate Symptom Score (IPSS)
The total IPSS score adds up the scores of the selected 7 questions answers in the table to get the total IPSS score, if the scoring is between.
0 to 7 please show mild symptoms.
8 to 19 for moderate symptoms.
20 to 35 are severe symptoms.
Interfere with daily life and affect quality of life, for example
(1) Most people have to drink less water before going out
(2) They are afraid to drink water before going to bed
(3) Sleep is affected by frequent nighttime urination
(4) Restricted access to places without public restrooms
(5) Outdoor activities are limited
According to the Olmsted survey, the risk of acute urinary retention increases significantly with age. According to the International Advisory Committee on Benign Prostatic Hyperplasia recommendations (1998), one of the following objectives must be achieved in any treatment of this disease to improve symptoms, reduce obstruction, and prevent the development of long-term comorbidities.
5. Treatment.
(1) Vigilant waiting
(2) Surgical treatment
(3) Interventional treatment
(4) Drug therapy
Benign prostatic hyperplasia can seriously affect the quality of life of older people, but it is rarely life-threatening and a proportion of patients have no significant development of symptoms. When a patient with BPH has no significant symptoms or has mild symptoms that do not affect quality of life, the doctor will recommend regular checkups and not give medication or surgery for the time being.
Surgical treatment
(1) Open surgery
(2) Transurethral resection of the prostate
(3) Transurethral resection of the prostate
(4) Possible side effects of surgery
Bleeding, impotence, retrograde ejaculation
Individual patients may require reoperation
Other treatments.
Urethral stent
Transurethral radiofrequency thermotherapy
Transurethral microwave thermotherapy
Transurethral needle ablation
Laser therapy
Drug Therapy
According to a market survey conducted by ISIS in Beijing and Shanghai, there are three major categories of medications currently available for the treatment of BPH.
(1) 5a reductase inhibitors: Paulownia (finasteride), etc.
(2) a-blockers
(3) botanicals
Description.
(1) Finasteride is a drug that targets the underlying cause of BPH, gradually reducing the size of the enlarged prostate and improving urinary symptoms.
(2) Since BPH is a chronic progressive disease, the effect of finasteride in reducing the size of the prostate gland will only be apparent after about 3 months.
(3) The effect of a blocker is to relax the urethra and improve urinary flow
(4) a-blockers are effective in improving symptoms but not in reducing prostate volume
Botanicals have been commonly used to treat prostatitis and BPH and can relieve symptoms
The mechanism of action of botanicals is not well understood
The above is only a general knowledge, the diagnosis and treatment of the disease still need to follow the medical advice of the specialist, each patient has individual differences, the treatment method varies from person to person.