Come on, please come and guess the riddle: “I can’t pee and pee” What is the most likely problem?
Photo source: Doctor Qi Weibo
I collected nearly a thousand votes and found that less than half of my friends answered correctly. In fact, “peeing and urinating” is really one of the most common reasons for elderly men to come to the urological emergency department, and most cases are caused by benign prostatic hyperplasia.
The human body is really a wonderful thing: the muscles and brain gradually shrink with age, but the prostate, which is a unique organ of men, gradually increases with age.
The prostate is located behind the pubic bone, in front of the rectum, just below the bladder, and the urethra passes through the prostate, so the prostate is the only way for men to urinate.
You should know that although the prostate plays an extremely important role in the production of semen components and urination for men, it also brings a lot of trouble to male friends— – Prostatitis, benign prostatic hyperplasia, prostate cancer.
Today, we will only discuss the culprit of the inability to urinate – benign prostatic hyperplasia.
Image source: Zhanku Hailuo
One of the most common prostate diseases in older men
Enlarged prostate is one of the most common conditions in older men. According to the report of the World Health Organization, the incidence rate of benign prostatic hyperplasia increases with age, and 50% of men over 50 years old will have benign prostatic hyperplasia. That is to say, the incidence of benign prostatic hyperplasia in men over 80 years old can reach 90%-100%[1][1].
Photo source Dr. Qi Weibo
Second, what causes benign prostatic hyperplasia?
Currently the most recognized DHT theory holds that the formation of benign prostatic hyperplasia requires two conditions: 1. advanced age; 2. functional testes.
In other words, Yue Buqun, the head of the Huashan School, was at risk of prostatic hyperplasia in old age. I am worried that one day I will have an enlarged prostate!
3. What are the manifestations of benign prostatic hyperplasia?
As mentioned earlier, the urethra passes through the middle of the prostate, and the hyperplasia of the prostate tissue will inevitably compress the urethra that passes through it. Therefore, the symptoms of benign prostatic hyperplasia are mainly urination symptoms – frequent urination, nocturia (≥ 2 times), difficulty urinating, thinning of the urine line and so on.
Photo source Dr. Qi Weibo
Many old men will attribute these changes in urination symptoms to “the normal reaction of old age”. If the children don’t pay attention to it, wait until “the urine can’t come out”. Unable to bear it, when I came to the doctor, I found out that the bladder was full of stones.
Tuyuan Qi Doctor Weibo
Please note that these “pearls” in the bladder are not pearls, but individual bladder stones.
Because the enlarged prostate can narrow the urethra, urine can accumulate in the bladder if it fails to empty. Urine accumulation is very easy to form stones, starting from a core and wrapping layer by layer to form the “pearl” in the picture.
4. How to treat benign prostatic hyperplasia?
Since benign prostatic hyperplasia is such a common problem in older men, is there any good way to treat it? At present, the treatment of benign prostatic hyperplasia is mainly divided into non-surgical treatment and surgical treatment.
Non-surgical treatment:
1. Watch and wait
Watchful waiting is only suitable when urination is not affected, or quality of life is not significantly affected.
2. Medication
If urination symptoms begin to develop gradually, after seeing the clinic, your doctor may recommend these medications: Alpha blockers such as tamsulosin, 5α-reductase inhibitors , such as finasteride, etc.
Image source: Zhanku Hailuo
Surgical Treatment:
If the symptoms of urination are still not satisfactorily controlled by drug therapy, then surgery can also be considered. There are many classic surgical options: transurethral resection of the prostate, transurethral plasma bipolar/laser Resection of the prostate, transurethral plasma bipolar/laser enucleation of the prostate, etc.
The principle of surgery is mostly the same, that is, to remove the excess prostate tissue with surgical instruments, so as to free the urethra from the surrounding of the prostate, restore the patency of the urinary channel, so that the urine flow can be From “trickle down” to “big river” again.
Five, this kind of treatment is absolutely impossible!
There was a man in his 40s and 40s who stuffed three large loach into his anus because he believed in the remedies for treating prostatic hyperplasia on the Internet… Please don’t follow suit. Teacher trouble!
Source: Internet
Alright, I’m Dr. Qi in the Department of Urology. I wish you a bright mind! Please remember to arrange a physical examination for your parents once a year!
References:
[1]Foo KT. What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)? World J Urol. 2019 Jul;37(7):1293-1296. doi : 10.1007/s00345-019-02691-0. Epub 2019 Feb 25. PMID: 30805683; PMCID: PMC6620380.
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