Come, please guess the puzzle: "Pee urine does not pee out of urine" What is the most likely problem?
Image source: Doctor Qi Weibo
I collected the votes of nearly a thousand people and found that less than half of the friends who answered correctly were. In fact, "peeing and peeing out of urine" is really one of the most common reasons why elderly men come to urological emergency department, and most of the cases are caused by prostatic hyperplasia.
The human body is really a wonderful thing: the muscles and brain gradually atrophied with age, but the prostate, as a unique organ of men, gradually increases with age.
The prostate is located behind the pubic bone, in front of the rectum, directly below the bladder, and the urethra passes through the prostate, so the prostate gland can be described as the only way for men to urinate.
You know, although the prostate has an incomparably important role for men in the production of semen components and urinary control, at the same time, it also brings a lot of trouble to male friends - prostatitis, prostatic hyperplasia, prostate cancer.
Today, we will only discuss the culprit who can't urinate and urinate - prostatic hyperplasia.
Image source: Stand Cool Helo
First, the most common prostate disease in elderly men
Prostatic hyperplasia is one of the most common diseases in older men. According to the World Health Organization, as far as prostatic hyperplasia is concerned, the incidence rate increases with age, and 50% of men over 50 years old will develop prostatic hyperplasia, and for each additional 10 years, the incidence increases by more than 10%, that is, the incidence of prostatic hyperplasia in elderly men over 80 years old can reach 90%-100%[1][1].
Image source Doctor Qi Weibo
Second, what exactly causes prostatic hyperplasia?
The most recognized theory of DHT believes that the formation of prostatic hyperplasia requires two conditions: 1. advanced age; 2. Functional testicles.
That is to say, Yue Buqun, the leader of the Huashan Sect, originally had a risk of prostatic hyperplasia after he was old, but after Mr. Yue practiced the Sunflower Treasure Book, no matter how old he lived, he no longer had to worry about prostate hyperplasia one day!
Third, what are the manifestations of prostatic hyperplasia?
As mentioned earlier, the urethra passes through the middle of the prostate, and the proliferation of the prostate tissue inevitably compresses the urethra that passes through it inside. Therefore, the symptoms of prostatic hyperplasia are also mainly urination symptoms - frequent urination, nocturia (≥ 2 times), dysuria, thinning of the urine line and so on.
Image source Doctor Qi Weibo
There are many old men who will attribute the change of these urination symptoms to "the normal reaction of people who are old", if the children do not care, wait until "pee and pee can not come out of the urine" is really intolerable, when you come to the doctor, a check found that the bladder has been covered with stones.
Note that these "pearls" in the bladder are not pearls, but bladder stones one by one.
Since the hyperplastic prostate can narrow the urethra, urine emptying disorders accumulate in the bladder. Urine buildup is very easy to form stones, starting from a core, layer by layer of wrapping to form the "pearl" in the picture.
4. How to treat prostatic hyperplasia?
Since prostatic hyperplasia is such a common problem in older men, is there any good treatment at the moment? At present, the treatment of prostatic hyperplasia is mainly divided into non-surgical treatment and surgical treatment.
Non-surgical treatment:
1. Observe the waiting
Observational waiting is only indicated when urination is not affected, or where quality of life has not been significantly affected.
2. Medication
If symptoms of urination begin to develop gradually, after seeing an outpatient clinic, the doctor may give these medication recommendations: α receptor blockers such as tamsulosin, 5α-reductase inhibitors, such as finasteride, etc.
Surgical treatment:
If drug therapy has not satisfactorily controlled urination symptoms, then surgery can also be considered, and there are many classic surgical options: transurethral prostate electroresection, transurethral plasma bipolar/laser prostate electroresection, transurethral plasma bipolar/laser prostatectomy, and so on.
The principle of surgery is mostly the same, that is, the excess prostate tissue is removed by surgical instruments, so that the urethra is liberated from the encirclement of the prostate and the patency of the urinary passage is restored, so that the urine flow can change from "trickle" to "big river".
Fifth, such treatment is absolutely impossible!
There was once a man in his forties and 40s who, because he listened to the home remedies for the treatment of prostatic hyperplasia on the Internet, stuffed three large loaches into his anus... Please don't follow suit, we don't cause trouble for proctology teachers!
Image source: Network
Well, I'm a urology doctor, I wish you a bright heart! Please remember to arrange a physical examination for your parents once a year!
bibliography:
[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.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
*The copyright of this article belongs to Tencent Medical Code, unauthorized media reprinting is prohibited, and illegal reprinting will be investigated for legal responsibility according to law. Individuals are welcome to forward to the circle of friends.