How to cure prostate enlargement

This symptom of prostate hypertrophy is relatively common in normal times, and it also causes many effects on the patient's body. If you want to cure prostate hypertrophy, first of all, you can't be careless in the method. You must find the right treatment plan so that you can recover quickly. In addition, you must judge according to the patient's physical manifestations. Don't wait until the condition worsens before treatment. Usually, you choose to use medication at the beginning.

Medication

Once BPH patients are diagnosed and evaluated, doctors should inform them that there are several different treatment options available. Patients should also discuss with their doctors and follow their guidance to choose a treatment that is effective and has few adverse reactions.

Individualized treatment should be recommended to patients. Patients with mild symptoms (symptom score 0-7 points) only need to wait and observe. Mc Connell et al. pointed out that patients with persistent urinary retention (urinary retention after at least one catheter removal), recurrent UTI, gross hematuria, bladder stones, renal insufficiency and huge bladder diverticulum are absolute indications for surgery.

1. Wait and see. There are not many studies on the natural course of BPH. The progression of the disease and the risk of complications are still uncertain. There is no doubt that for patients with symptomatic BPH, the progression of the disease is sometimes inevitable, but the symptoms of some patients may spontaneously alleviate or disappear.

Retrospective studies on the natural course of BPH are prone to bias, which is related to case selection and the type and extent of follow-up, while there are few reports on prospective studies. Choosing to wait and see does not mean letting the disease develop passively.

A comprehensive assessment should be conducted once a year, including IPSS, DRE, urine routine, renal function test, urodynamics test, B-ultrasound and necessary imaging test. When in doubt, the serum PSA level should be measured to alert the occurrence of prostate cancer (Pca). A series of patients were observed for 2 to 2.5 years without treatment, and 33% to 60% of them improved their symptoms, many patients were stable, and 30% to 45% of patients required surgical treatment.

In another group of 112 BPH patients, about 38% required prostatectomy, while only 8% of 945 patients without LUTS required surgery. The changes in prostate volume and Qmax are the most predictive of surgical outcomes. The risk of surgery by age is about 10% at 50 years old and about 50% at 70 years old.

As mentioned above, observation and waiting are suitable for patients with mild symptoms (score 0-7). Patients with moderate to severe symptoms can also try it if they insist, but the optimal follow-up period and timing of treatment intervention have not yet been determined.

2. Drug treatment

(1) α-receptor blockers: The human prostate and bladder base both contain α1 adrenergic receptors. Forray et al. pointed out that the prostate has a contraction response to the corresponding stimulant. The contraction of the prostate and bladder neck is mainly regulated by the α1 receptor subtype. α-receptor blockers can alleviate and improve the subjective and objective symptoms of some patients to varying degrees. According to the receptor selectivity and its half-life, α-receptor blockers can be divided into several types.

Phenolamine and prazosin are non-selective α-receptor blockers that have good efficacy in relieving symptoms. However, phenolamine is no longer recommended due to its large adverse reactions and lack of selectivity. It is very important to control the dosage of prazosin. High doses will not improve the efficacy, but will increase adverse reactions. Common adverse reactions include orthostatic hypotension, dizziness, fatigue, retrograde ejaculation, nasal congestion and headache.