Author: Wang Zhihua (Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology)
The anatomical position of the prostate is special, located in the deepest part of the pelvic cavity, which can be said to be "invisible, untouchable".
Symptoms of prostate disease are characterized by dysuria called lower urinary tract symptoms, including bladder irritation, urinary tract obstruction, and urinary incontinence:
· Irritation symptoms are mainly urinary frequency, urgency and dysuria;
· Symptoms of obstruction include dysuria, interruption of urinary flow, and urinary retention.
Source: Stand Cool Helo
1. Increased urinary frequency and nocturia
Urinary frequency refers to a significant increase in the number of times the patient feels a desire to urinate, and the amount of urine per urination decreases. In severe cases, urinate once every few minutes, and the amount of urine per urine is only a few milliliters. Normal adult males urinate 4 to 5 times during the day and no more than 2 times at night, with a urine output of about 300 ml each time. Urination is frequent if you urinate 1 time or nocturnal urine more than 2 times during the day. Urinary, genital tract inflammation, bladder stones, bladder tumors, prostate hyperplasia and other causes can cause frequent urination.
Nocturnal urination is also called nocturia, and after urinating in the middle of the night, it is often necessary to get up several times a night. The most common early symptom of benign prostatic hyperplasia is frequent urination, mainly increased nocturia, and increased nocturia can also occur in patients with cardiac insufficiency, which should be noted in patients with heart disease.
If only the frequency of urination increases, and the amount of urine per time does not decrease, or even increases, it may be physiological, such as drinking a lot of water, eating diuretic fruits (such as watermelon); it may also be pathological, such as diabetes, diabetes insipidus or renal failure polyuria period; sometimes mental factors can also cause frequent urination, such as insomnia, anxiety, etc.
2. Urgency
Under normal circumstances, if the surrounding environment does not permit, when there is a desire to urinate, you can hold urine and delay urination.
Urgency is a sudden onset of a strong desire to urinate, and it is difficult to be subjectively suppressed and delayed urination. Urinating has a sense of urgency, can't wait, can't control, urine intention to urinate as soon as possible, a little delay, urine will be discharged uncontrollably.
Urinary frequency, urgency, and dysuria often occur at the same time, causing and influencing each other.
Source: Stand Cool Helo
3. Painful urination
Dysuria is pain in the urethra, bladder, or perineum (the area between the anus and scrotum) when urinating. Pain manifests as a burning sensation, ranging from mild to severe, with severe pains such as knife cutting. Common in urethritis, prostatitis, prostatic hyperplasia, vesicles, cystitis, urinary tract stones, pyelonephritis, etc.
The doctor will further clarify the diagnosis of the disease according to the characteristics of urinary pain:
· Pain at the onset of urination, or difficulty urinating: lesions are mostly in the urethra and are common in acute urethritis.
· Pain at the end of urination with urgency: lesions are mostly in the bladder and are common in acute cystitis.
· Pain at the end of urination is obvious, and pain is still felt after urination, or "empty pain", or pain without urination: lesions are mostly in the urethra or adjacent organs, such as bladder triangularitis, prostatitis, etc.
· Abrupt interruption of urination with pain or urinary retention: seen in the bladder, urethral stones, or urinary tract foreign body.
· Poor urination with swelling pain: the elderly often suggest prostatic hyperplasia and may also be seen in urethral stones.
· Urinary tingling and burning pain: more common in acute inflammatory stimuli, such as acute urethritis, prostatitis, cystitis, etc.
Urinary frequency, urgency, and dysuria often occur at the same time and are called bladder irritation symptoms. There are many common causes, such as prostatic hyperplasia, bladder tumors, bladder stones, urethral stones, urinary tract infections, etc.
4. Dysuria
Dysuria includes hesitation in urination, laborious urination, weakness in the urine line, bifurcation, thinning, incomplete urination, and urinary dripping.
· Hesitancy: refers to the delay in the start of urination, often rushing to the toilet, but waiting for a period of time to urinate.
· Laborious urination: refers to the need to increase abdominal pressure to start urination, that is, to hold the breath and drum the stomach hard to urinate out.
· The urine line is thinner and the range is shorter: sometimes it even causes urine to drip onto the pants and feet.
· Bifurcation of urine flow: refers to the formation of a double strand or scattering of urine flow.
· Incomplete urination: refers to the feeling that there is urine in the bladder that has not been excreted after urination, but it cannot be urinated.
· Urination drip: refers to the fact that after urination, there is still a small amount of urine dripping from the urethral opening, which is inexhaustible.
Source: Stand Cool Helo
5. Urinary retention
Urinary retention is divided into two categories: acute and chronic:
· Acute urinary retention is characterized by a sudden inability to urinate and retention of urine in the bladder. It is common in patients who are afraid to urinate vigorously after abdominal and perineal surgery, as well as benign prostatic hyperplasia, prostate cancer, or urethral stenosis.
· Chronic urinary retention manifests as dysuria, bulging, discomfort, or pain in the lower abdomen.
6. Urinary incontinence
Urinary incontinence is when urine cannot be controlled and flows out. It can be divided into four types:
· Persistent urinary incontinence (loss of urine control of the bladder, persistent leakage of urine)
· Overflow incontinence (a small amount of urine overflowing from a full bladder, just as siltation downstream of a river causes flooding upstream)
· Urge urinary incontinence (is an uncontrollable feeling of urgency, often suddenly feel urgent, too late to go to the bathroom has urine out of the flow)
· Stress urinary incontinence (refers to urinary leakage when there is pressure on the bladder, such as during exercise, coughing, sneezing, laughing)
Urinary incontinence associated with prostatic hyperplasia, mainly overflow incontinence and urgent urinary incontinence.
7. Hematuria and hematosis
Hematuria is the urine containing blood cells, which are divided into gross hematuria and microscopic hematuria.
Normally, there are no red blood cells in the urine. As the name suggests, hematuria in the naked eye refers to the fact that the naked eye can see blood, which can be a reddish cloud, a washed meat, soy sauce color, or a blood clot. Usually 1,000 ml of urine contains 1 ml of blood that is reddish and visible to the naked eye.
If the appearance of the urine does not change significantly, after centrifugation of the urine, microscopy is used to observe more than 3 red blood cells in each high-power field of view, called microscopic hematuria. Therefore, not all hematuria can be found by the eye, and it can be seen with the eyes to show that hematuria is more serious. However, any degree of hematuria can not be easily let go, should first consider the possibility of malignant tumors, need to go to the regular hospital in time, find out the cause, and actively treat.
It is worth noting that hematuria is often a red flag for disease, but the severity of hematuria does not necessarily represent the severity of the disease. In addition, the redness of urine is not all hematuria, some drugs and foods can also make urine appear red, orange and brown, such as rhubarb, rifampicin, tetracycline drugs and so on.
Hematospermias are semen containing blood, mostly caused by inflammation of the prostate and seminal vesicles, and generally disappear on their own within a few weeks. If it persists for more than a few weeks, lesions such as genital tuberculosis and prostate tumors need to be excluded.
brief summary
In short, if there are symptoms such as urinary frequency, urgency, painful urination, difficulty urinating, etc., there may be prostate problems, such as prostatic hyperplasia, prostatitis and even prostate cancer, but it may also be caused by other diseases, such as bladder diseases (cystitis, bladder cancer, etc.), urinary tract infections or urinary tract stones and so on.
Therefore, after the above symptoms appear, go to a regular hospital for examination and treatment, do not delay diagnosis and treatment or take medication without authorization, so as not to miss the best time for treatment.
*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.
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