benign prostatic hyperplasia
Introduction
Introduction to benign prostatic hyperplasia Benign prostatic hyperplasia (BPH) is mainly caused by different degrees of glandular and/or fibrosis caused by sexual hormone metabolism in the elderly, and the proliferation of muscle tissue leads to an increase in prostate volume, destruction of normal structure and a series of dysfunction diseases. Benign prostatic hyperplasia is a common disease in men and middle-aged men, and about half of men over the age of 50 develop clinical symptoms. The hyperplastic prostate squeezes the urethra, causing a series of symptoms of urinary dysfunction, such as urinary urgency, urinary flow, and urinary incontinence. These symptoms seriously affect the quality of life of patients. Failure to treat them in time can lead to many serious complications (such as acute urinary retention, stones, renal insufficiency, etc.) and even endanger the lives of patients. basic knowledge The proportion of illness: 1.3% Susceptible people: male Mode of infection: non-infectious Complications: bladder diverticulum hydronephrosis hematuria renal failure
Cause
Causes of benign prostatic hyperplasia
Hormone factor (25%)
Some scholars believe that the changes in the balance between estrogen and androgen may be the cause of prostate hyperplasia caused by prostate matrix-inducing activity. Multiple fibrous adenoma-like nodules that appear in the area around the prostatic urethra may originate from the glands surrounding the urethra, rather than in the true fibromuscular prostate (surgical envelope), which is squeezed aside by growing nodules . Hyperplasia may involve the prostate lateral wall (lateral lobular hyperplasia) or the bladder neck lower margin tissue (middle lobular hyperplasia).
Damage factor (15%)
When the urethral lumen of the prostate is damaged, the urine outflow is gradually blocked, and there is a bladder detrusor hypertrophy, trabecular formation, small chamber formation and diverticulum. Long-term urinary tract obstruction, such as urethral stricture, bladder or urethra stones, affects the smooth flow of the urinary tract, causing the bladder to be in a state of urine filling, causing adverse stimulation to the prostate. Bladder emptying does not completely cause urinary siltation, infection is easy, and there are secondary inflammatory changes in the bladder and upper urinary tract. Urinary siltation is easy to form stones. Long-term obstruction, even incomplete obstruction, can cause hydronephrosis and impair kidney function.
Life factor (15%)
Excessive sex, masturbation, interruption of sexual intercourse and irritating food can cause hyperemia of the testes and prostate. Repeated excessive congestion, testicles tend to shrink, prolonged prostate is easy to hypertrophy; and bacteria caused by repeated infections near the prostate, inflammation can induce prostate hyperplasia; because the lower urinary tract is not smooth, easy to make the bladder too full of urine, thereby stimulating Sexual organs are congested.
Dietary factors (11%)
Often drinking or eating spicy spicy food is also prone to benign prostatic hyperplasia. Alcohol is very harmful to the prostate. There are many long-term and large drinking history of benign prostatic hyperplasia.
Prevention
Benign prostatic hyperplasia prevention
Once you find symptoms such as nocturia, you should go to the regular urology department of the urology department to conduct a related examination. Once the diagnosis is made, the professional urologist should follow the principle of regular treatment and formulate the appropriate conditions for the patient. Treatment programs.
Complication
Benign prostatic hyperplasia complications Complications, bladder diverticulum, hydronephrosis, renal failure
Acute urinary retention, urinary tract infection, bladder diverticulum, stones, hydronephrosis, hematuria, renal failure and other complications due to improper treatment or improper treatment.
Symptom
Symptoms of benign prostatic hyperplasia Common symptoms Urinary urinary urinary urinary frequency Acute urinary retention Incontinence Urinary incontinence Bladder insufficiency Inability to hematuria After drip leaching anal
1. Frequent urination is often the first symptom of patients with benign prostatic hyperplasia. The early stage is caused by the stimulation of prostate congestion. The nighttime is more obvious, the obstruction is aggravated, and the residual urine volume of the bladder is increased. The frequency of urination is gradually worsened. This is because the bladder is often partially filled. , resulting in a reduction in effective capacity.
2. Urinary dysfunction Progressive dysuria is the most important symptom of benign prostatic hyperplasia. The development is often very slow. Sometimes it is considered that the natural phenomenon of the elderly is not noticed. In addition to the medical history, the patient should directly observe the urination and understand the difficulty of urinating. Degree, mild obstruction, slow urination, intermittent, post-urine drip, increased urinary dying after obstruction, shortened range, thin and weak urinary line, and finally drip.
3. The urinary retention obstruction is increased to a certain extent. When urinating, the urine in the bladder can not be drained. The residual urine of the bladder appears. The larger the residual urine volume, the heavier the obstruction. Excessive residual urine can make the bladder lose its contraction ability. Urinary retention occurs gradually, and urinary incontinence can occur. It is caused by excessive inflation of the bladder and a small amount of urine overflowing from the urethra. It is called overflow urinary incontinence. Acute urinary retention may occur in any stage of benign prostatic hyperplasia, mostly due to climate change. Drinking, tired, etc. caused the prostate to suddenly become congested, caused by edema.
4. Other symptoms of prostatic hyperplasia with infection, there may be frequent urination, urgency, urinary pain cystitis phenomenon, there are more obvious symptoms when there are stones, and may be accompanied by hematuria; prostatic hyperplasia due to local congestion can occur painless hematuria, late There may be signs of hydronephrosis and renal insufficiency. Long-term dysuria leads to increased abdominal pressure, inguinal hernia, prolapse or internal hemorrhoids, occasionally masking the symptoms of benign prostatic hyperplasia, causing errors in diagnosis and treatment.
Examine
Benign prostatic hyperplasia
1. Physical examination: If the patient is weak, pale, drowsiness, high blood pressure, fast pulse, deep breathing, the possibility of uremia should be thought of. Abdominal examination may find increased kidney with tenderness of the rib angle, indicating that hydronephrosis has been secondary. The pubic bone should be checked for inflated bladder. The bladder surface of the urinary retention is smooth, soft, and no nodular. Patients with a long history must pay attention to whether there is a cancer, hemorrhoids, narrow foreskin, and normal urethra.
Digital rectal examination: first understand the anal sphincter tension, anal canal relaxation should think of neurogenic bladder, prostate enlargement, middle sulcus disappear, smooth surface, histologically seen hyperplastic nodules due to the outer envelope formed by the outer envelope There is no nodular change in the referral, and the enlargement of the prostate can be asymmetrical. If the enlarged part of the prostate protrudes into the bladder, the rectal examination may not reach the upper edge of the prostate. The texture of the prostate may be softer or harder. The proportion of glandular components and fibrous smooth muscles, if the prostate enlarges irregularly, with nodules or even hard as stones, the possibility of prostate cancer should be considered.
During the physical examination, the ball sponge muscle reflex should be monitored, the lower extremity movement and perception should be normal, and possible neuropathy should be found.
2. Perform blood and urine tests to assess the patient's kidney function and to rule out urinary tract infections, as infections in the male reproductive system or any part of the urinary system may cause dysuria, so some symptoms of benign prostatic hyperplasia Like prostatitis, it is easy to cause misdiagnosis.
3. Ultrasound examination (also used for the diagnosis of prostate cancer) can monitor the size of the prostate for the patient. In addition, through a pressure-sensitive sensing device, the doctor can measure the urinary flow force when the patient urinates, and the urinary flow force is often reduced. It is suggested that the patient may have benign prostatic hyperplasia.
4. Renal angiography (intravenous injection of contrast agent for urinary X-ray examination) is mainly used for the diagnosis of kidney and ureteral diseases, but it also has a certain diagnostic value for benign prostatic hyperplasia, through pyelography, the doctor can It is found that the patient has occlusion or abnormal stenosis in the entire urinary tract. Prostate urethral stricture will highly suggest the presence of benign prostatic hyperplasia.
5. Through cystoscopy, we can directly find the stenosis or blockage in the patient's urethra. Before performing cystoscopy, we should first inject a certain amount of anesthetic into the urethra through the urethral orifice, and then the probe with the probe. Inserted into the patient's urethra, so we can use the monitor to search for stenosis in the patient's urethra.
Diagnosis
Diagnosis and differentiation of benign prostatic hyperplasia
There are many clinical symptoms similar to prostate hyperplasia, such as neurogenic bladder dysfunction, bladder neck contracture, prostatitis, prostate cancer, diabetes and alcoholism caused by peripheral neuropathy, phimosis, urethral stricture (inflammation, injury, surgery concurrent) Symptoms, tumors, etc., through the above detailed examination, can be identified one by one.
