What to do if you have prostate hyperplasia

Middle-aged men should pay special attention to prostate problems. Although most men have some prostate problems, they will not feel anything in mild cases and do not need treatment. However, when the problem gets worse, there will be many complications. In particular, the problem of prostate hyperplasia should be taken seriously. So what should we do if we have prostate hyperplasia? It depends on whether it is serious. If it is not serious, we can observe it first, otherwise we need to take medication.

1. Observe and wait

If the symptoms are mild and the IPSS score is below 7, the condition can be observed and no treatment is required.

2. Drug treatment

(1) 5α-reductase inhibitors are suitable for the treatment of BPH patients with enlarged prostate and moderate to severe lower urinary tract symptoms. Studies have found that 5α-reductase is an important enzyme for the conversion of testosterone to dihydrotestosterone. Dihydrotestosterone plays a certain role in prostate hyperplasia, so the use of 5α-reductase inhibitors can inhibit hyperplasia to a certain extent.

(2) α1-receptor blockers are suitable for BPH patients with moderate to severe lower urinary tract symptoms. It is currently believed that this type of drug can improve urinary tract dynamic obstruction, reduce resistance and improve symptoms. Commonly used drugs include chlorpheniramine. Common side effects of this type of drug include dizziness, headache, fatigue, drowsiness, postural hypotension, abnormal ejaculation, etc.

(3) Others include M receptor antagonists, herbal preparations, and traditional Chinese medicine. M receptor antagonists block bladder M receptors, relieve excessive detrusor contraction, and reduce bladder sensitivity, thereby improving the urinary symptoms of BPH patients. Herbal preparations such as Prosperide are suitable for the treatment of BPH and related lower urinary tract symptoms.

In summary, a comprehensive assessment of the condition should be made before drug treatment, and the side effects of the drugs and the possibility of long-term medication should also be fully considered. Long-term follow-up should be conducted to observe the effects of drug treatment, and urodynamic tests should be performed regularly to avoid delaying the timing of surgery.

3.Surgery

Surgery is still an important treatment for BPH and is suitable for BPH patients with moderate to severe LUTS that have significantly affected their quality of life. Classic surgical methods include transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and open prostatectomy. Currently, TURP is still the "gold standard" for BPH treatment.

Indications for surgery are: ① Symptoms of lower urinary tract obstruction, obvious changes in urodynamics, or residual urine of more than 60 ml; ② Severe symptoms of unstable bladder; ③ Upper urinary tract obstruction and renal function damage have been caused; ④ Multiple episodes of acute urinary retention, urinary tract infection, and macroscopic hematuria; ⑤ Patients with bladder stones. ⑥ Patients with inguinal temples, severe hemorrhoids or prolapse of the anus, and clinical judgment that it is difficult to achieve treatment effects without relieving lower urinary tract obstruction. For patients with long-term urinary tract obstruction, obvious renal function damage, severe urinary tract infection or acute urinary retention, a urinary catheter should be placed first to relieve the obstruction, and surgery should be performed after the infection is controlled and renal function is restored. If it is difficult to insert the urinary catheter or the long intubation time has caused urethritis, suprapubic cystocentesis can be performed instead. The indications for emergency prostatectomy should be strictly controlled.