Learn about prostate hyperplasia

Learn about prostate hyperplasia

Prostatic hyperplasia (BPH) is a common disease in elderly men characterized by dysuria, and clinical symptoms usually appear after the age of 50. It is a common benign disease, also known as benign prostatic hyperplasia. The human prostate begins to proliferate at the age of 35, and clinical symptoms usually appear after the age of 50. Prostatic hyperplasia can cause urinary tract obstruction and eventually lead to renal damage in patients.

The cause of prostate hyperplasia is still unclear. It is currently believed that advanced age and functional testicles are important factors in prostate hyperplasia, among which male hormones, multiple growth factors, steroid hormone receptors, etc. have a certain relationship with prostate hyperplasia.

Prostatic hyperplasia can cause bladder outlet obstruction. The degree of obstruction is not proportional to the size of prostatic hyperplasia, but is directly related to the location and shape of the hyperplastic gland. If the gland protrudes into the bladder (middle lobe hyperplasia), it is very easy to cause bladder outlet obstruction; if the hyperplastic gland protrudes into the urethra, the prostatic urethra can be elongated, bent, compressed and narrowed, causing dysuria. If the obstruction is not relieved for a long time, the detrusor atrophies and loses its decompensation ability, the bladder cannot be emptied and residual urine occurs. In severe cases, the bladder contraction is weak and filling urinary incontinence occurs. Long-term dysuria causes the bladder to expand highly or the high pressure in the bladder, which can cause vesicoureteral reflux, and eventually cause hydronephrosis and renal damage. Due to the retention of urine in the bladder after obstruction, secondary infection and stones may occur.

What are the symptoms of prostate hyperplasia?

1 Frequent urination is the first symptom of patients with prostatic hyperplasia. In the early stage, it only manifests as a significant increase in the number of nocturnal urination. As the obstruction worsens, urination may also occur during the day.

2 Progressive dysuria is a typical symptom of patients with prostatic hyperplasia. It manifests as slow and intermittent urination and dripping after urination. When the urinary tract obstruction is severe, urination is laborious, the urine stream is thin and weak, and finally drips.

3. Urinary retention. In patients with severe obstruction, the amount of residual urine in the bladder increases, which can lead to weak bladder contraction, urinary retention, and overflow incontinence. At any stage of prostatic hyperplasia, the prostate may suddenly become congested and edematous due to cold, fatigue, drinking, etc., resulting in acute urinary retention.

4 Secondary symptoms: Bladder irritation may occur when combined with infection; urine flow interruption may occur when combined with bladder stones; long-term urination difficulties may lead to hydronephrosis and renal failure. Long-term abdominal pressure urination may also be combined with hernia, hemorrhoids or rectal prolapse.

Prostate hyperplasia related auxiliary examination

1. Rectal examination should be performed after the bladder is empty to ensure the accuracy of the examination.

2 B-mode ultrasound can measure the volume of the prostate (it is necessary to hold urine) and check whether the internal structure protrudes into the bladder. Ultrasound is currently commonly used to measure residual urine. Before the examination, the patient is asked to urinate first and empty the bladder as much as possible.

3 Urodynamic examination includes urine flow rate, bladder pressure and urethral pressure measurement, which is a method to determine the function and degree of damage of detrusor muscle. Normal urine flow rate is 25ml/s. If the maximum urine flow rate is less than 15mI/s, it indicates that urination is not smooth; if the maximum urine flow rate is less than 10ml/s, it indicates that the obstruction is more serious, which is often one of the indications for surgery. The urine volume should be guaranteed to be greater than 150m to be effective.

4 Serum prostate-specific antigen (PSA) measurement: When the prostate is large, nodular or hard, blood PSA should be measured to rule out the possibility of concurrent prostate cancer.

Principles of treatment for prostatic hyperplasia

Drug treatment has a good effect on cases with mild symptoms.

The main surgical treatment methods include transurethral resection of the prostate, transurethral green laser resection of the prostate, suprapubic transvesical prostatectomy, etc.