The performance of benign prostatic hyperplasia and treatment

The performance of benign prostatic hyperplasia and treatment

Overview

Benign prostatic hyperplasia is a common disease of elderly men, mostly in the age of onset after the age of 50, its incidence with age growth rate has been increased, has become a common disease in urology. Pathological causes of disease and benign prostatic hyperplasia in androgen and estrogen imbalance close. The main one is male testicular androgen, the role of the enzyme, into testosterone-dihydrochloride, is one dihydrochloride testicular androgen stimulating hormone activity of benign prostatic hyperplasia. The effect of estrogen on benign prostatic hyperplasia also affected to some extent. Clinical symptoms of benign prostatic hyperplasia, as the pathological changes gradually emerging. Early symptoms of bladder compensatory and not obvious, and thus patients often can not accurately recalled the length of the course, with the condition and increase the variety of symptoms appear.



1. Frequency and urgency: The most common symptom is the frequency, and gradually increase, especially the growing number of nocturnal enuresis.



2. Sexual dysuria: mainly from the urine for the slow, laborious urination, urinary unable to radio and urine of small, flow drops Lek, subparagraph, such as not urinating and voiding.



3. Incontinence



4. Acute urinary retention: If Shouliang, drinking and fatigue caused by incentives such as the bladder neck glands and congestion and edema, acute retention of urine can occur. Patients with bladder extreme swelling, pain, frequent urinary Italy, quite disturbed, difficult to sleep.



5. Hematuria: ranging from the amount of bleeding for more than intermittent, sometimes massive bleeding, bladder filled with blood clots, must be addressed urgently.



6. Renal failure symptoms: late because of long-term urinary obstruction caused by the two renal dysfunction, manifested as loss of appetite, nausea, vomiting and anemia.



7. Other symptoms: difficulty in urination due to the long-dependent increase in abdominal pressure urination, can cause or aggravate hemorrhoids, such as hernia and Tuogang.



Check



Digital rectal up: digital rectal attending the diagnosis of benign prostatic hyperplasia is an important Buju, prostate enlargement can be reached, smooth surface and medium hardness.



Cystoscopy: cystoscopy can directly observe the proliferation of the prostate, bladder and understand whether other diseases, such as tumor, stones, diverticulitis, so as to determine the treatment method.



Residual urine side set: the number of bladder residual urine bladder compensatory reflect the seriousness of the failure, so this is an important step towards the diagnosis, treatment decision is also one of the factors.



Bladder contrast: not a cystoscopy possible cases of bladder contrast, in addition to observe the bladder neck filling defect, but also observe whether bladder stones, cancer, diverticulitis and ureteral reflux, and so on.



B-ultrasound examination: the size of the prostate, including diameter, with the diameter from top to bottom diameter.



Urodynamic examination: benign prostatic hyperplasia caused by lower urinary tract obstruction, the largest flow rate decreased urination period of increased pressure within the bladder.



Radioisotope kidney plans: to get the two secretion and renal pelvis and ureter drainage situation.



Other inspections:

Have renal function tests and urine culture, and so on. For surgery, it should be for heart, lung, liver function tests.



Treatment



1. Renal damage with uremia are obvious: First of all suprapubic bladder puncture ostomy drainage urine.



2. Prostate smaller, lighter symptoms, residual urine <60 ml who may be drug treatment, physical therapy, transurethral resection of the prostate, and other open manner.



3. Ⅱ degrees below the prostate, residual urine> 60 ml, can be electrified + transurethral resection of the prostate, excision, laser transurethral resection of the prostate, the urethra balloon dilatation, open surgery, including prostate removed.



4. Ⅲ of the prostate over open prostate removal surgery.



5. Systemic situation worse, residual urine> 60 ml, can not tolerate surgery or general situation is good, residual urine> 60 ml, but declined surgery, can be placed mesh of the stent memory alloys.



6. Associated with bladder stones (> 3 cm) or bladder cancer: prostate surgery open surgery. 7. Systemic support therapy.



8. Antibiotic treatment to prevent infection.