Prostate disease
Introduction
Introduction to prostate disease Prostate disease is a common disease in adult men, usually referred to as prostatitis, benign prostatic hyperplasia and prostate cancer. Prostate diseases can be characterized by frequent urination, urgency, dysuria, hematuria, dysuria, urinary incontinence, urinary bifurcation, post-urine drainage, increased number of nocturia, and white after urine or after stool. And complicated sexual dysfunction, including loss of libido, premature ejaculation, ejaculation pain, erectile dysfunction and impotence. Even secondary to urinary tract damage, as well as systemic symptoms. basic knowledge The proportion of illness: 0.01%-0.03% (probability of disease over 50 years old 0.5%-1%) Susceptible people: male Mode of infection: non-infectious Complications: impotence, erectile dysfunction, premature ejaculation, loss of libido
Cause
Cause of prostate disease
Prostatitis
Type I prostatitis pathogen infection is the main cause of the disease. Due to the low resistance of the body, bacteria or other pathogens with strong virulence are infected with the prostate and rapidly grow and multiply, mostly due to blood infection and transurethral retrograde infection. The pathogens are mainly Escherichia coli, and the vast majority are single pathogen infections. The pathogenic factors of type II prostatitis are mainly pathogen infections, but the body's resistance is strong or / and the pathogen's virulence is weak. The main cause is retrograde infection, and the pathogen is mainly Staphylococcus. The pathogenesis of type III prostatitis is unclear, and the etiology is very complicated. Most scholars believe that the main cause may be the combination of pathogen infection, inflammation and abnormal pelvic floor neuromuscular activity.
2. Prostatic hyperplasia
The occurrence of benign prostatic hyperplasia must have two important conditions: age growth and functional testis. However, the specific mechanism of benign prostatic hyperplasia is still unclear, probably due to the balance of epithelial and mesenchymal cell proliferation and apoptosis. Related factors are: androgen and its interaction with estrogen, interaction of prostate mesenchymal gland epithelial cells, growth factors, inflammatory cells, neurotransmitters and genetic factors.
3. Prostate cancer
The risk factors for prostate cancer are not clear, but some of them have been confirmed. One of the most important factors is heredity. If an immediate family member (brother or father) has prostate cancer, the risk of prostate cancer is doubled. Exogenous factors can influence the progression from so-called latent prostate cancer to clinical prostate cancer. Confirmation of these factors is still under discussion, but a high animal fat diet is an important risk factor.
Prevention
Prostate disease prevention
Prostatitis
Avoid prostate congestion, life should pay attention to avoid spicy, quit smoking and alcohol, quit smoking, long-term sedentary, frequent sexual life and so on. Develop good habits, drink water regularly, and don't urinate. Pay attention to the combination of work and rest, which can improve the blood circulation of the prostate, improve the balance of yin and yang, and prevent the occurrence of aseptic prostatitis.
2. Prostatic hyperplasia
Eat less spicy spicy food; do not over-urine, otherwise the bladder will be overfilled, which will weaken the bladder detrusor tension and make urination difficult. Do not overwork, overwork will burn the gas, lack of gas will cause urination, easy to cause urinary retention. Avoid sedentary, sedentary easy to make the perineal congestion, causing difficulty in urinating. Drink plenty of water and reduce the amount of water at night to avoid overfilling the bladder after sleep. Drink plenty of water during the day. Be cautious of drugs that can cause urinary retention, such as atropine, belladonna tablets.
3. Prostate cancer
Genetics is an important risk factor for the development of prostate cancer into a clinical form, and exogenous factors may have an important impact on this risk. The key issue now is that there is not enough evidence to suggest that lifestyle changes (reducing animal fat intake and increasing intake of fruits, cereals, vegetables, red wine, etc.) will reduce the risk of morbidity.
Complication
Prostate complications Complications, impotence, erectile dysfunction, premature ejaculation, libido
No relevant information.
Symptom
Symptoms of prostatic disease Common symptoms Urinary frequency Urinary urgency Prostate sensation Nocturia Increased urine Drops White urine pain Urine bifurcation dysuria and urinary retention Incontinence Hematuria
Prostatitis
That is, inflammation of the prostate. It can be roughly divided into acute and chronic, but the cause of the disease is caused by bacterial and non-bacterial infections. The main symptoms of dysuria, urinary white, urinary urgency, frequent urination, lower abdomen perineal pain and discomfort; more serious, may cause fever.
2. Benign prostatic hyperplasia
Benign prostatic hyperplasia is the most common benign disease in the cause of urinary dysfunction in middle-aged and elderly men. Mainly manifested as histological hyperplasia of the prostate interstitial and glandular components, anatomical enlargement of the prostate, clinical symptoms of the lower urinary tract symptoms, and urodynamic bladder outlet obstruction.
3. Prostate cancer
There are no special symptoms in the early stage of prostate cancer. When cancer cells grow, the prostate body is hypertrophied, and the urethra is squeezed to cause dysuria. These cancer cells can spread to other parts of the body as the blood flows. The general course of disease is slow and time-lapse, and the late stage can cause bladder neck obstruction and distant metastasis.
Examine
Prostate disease examination
Rectal examination
Prostate examination usually involves a digital rectal examination. The prostate is touched by the rectum. You can understand the size, texture, presence of induration, pain, etc. of the prostate. You can also indirectly understand the function of the urethral sphincter by feeling the tension of the anal sphincter. If the surface of the prostate is indurated, the possibility of prostate cancer should be considered. Serum PSA should be checked and a prostate biopsy should be performed if necessary.
2. Ultrasound
It is simple and easy to understand and evaluate the upper urinary tract, and can be repeatedly checked, such as prostate size, residual urine volume and so on.
3. X-ray inspection
It is of great value in the diagnosis of prostate diseases. For example, the plain film can detect the presence or absence of calcification or stone shadow in the prostate. Contrast can help check for prostate hyperplasia or prostate cancer. CT examination is more important for the differential diagnosis of prostate diseases.
4. Organizational inspection
It is useful for identifying the nature of a prostate mass and is extremely helpful in defining the tissue typing and cytological features of prostate tumors. It can be passed through a rectal aspiration biopsy or a perineal biopsy. It has some pain and trauma, but it is very necessary.
5. Lower urinary tract activity mechanics examination
This test is very helpful for the diagnosis of benign prostatic hyperplasia. Cystoscopy can directly observe the posterior urethra, fine sputum and prostatic area of the prostate and lateral lobe, which is also very important for the diagnosis of prostate disease.
6. Prostatic fluid
The normal prostatic fluid is a thin milky white liquid. Microscopic examination: There are many lecithin bodies, and the number of white blood cells per high power field is less than 10, and occasionally sperm. In prostatitis, white blood cells or pus cells are 10 or less per high power field, and some piles, lecithin bodies are reduced, and trichomoniasis can be found. Prostatic fluid can also be cultured in bacteria.
7. CT and MRI examination
Both CT and MRI are suitable for the diagnosis of bladder and prostate diseases. However, for the indication of the invasion of the lesion to the adjacent adipose tissue of the organ, MRI is superior to CT for displaying the intrinsic tissue structure of the prostate, showing the central zone and the surrounding zone as well as the transition zone.
Diagnosis
Diagnosis and identification of prostate disease
No relevant information.
