Benign prostatic hyperplasia is a common disease in andrology, which endangers the health of middle-aged and elderly people, and will cause urination problems of patients. Men with BPH want to know what causes BPH. Let me introduce the causes of prostate hypertrophy. I hope I can help you.
I. people who don't pay attention to their diet and like to eat spicy food, greasy food, smoke and drink are more likely to suffer from prostate hypertrophy, because spicy food and alcohol stimulate the prostate and urethra, which can cause discomfort or vasodilation, resulting in congestion, edema and other symptoms of the prostate, which will reduce the resistance of the prostate. Other studies have shown that obesity caused by too much nutrition is related to prostate hypertrophy. Excessive consumption of nutritious foods such as fat, meat and dairy products will increase the risk of prostate hypertrophy. So eat more fruits and vegetables in your daily diet. In addition, you can supplement vitamin D. To reduce the risk of prostate hypertrophy.
Second, there is no good defecation habit. Some people are used to holding their urine. This is a very bad habit. Often holding their urine will deposit toxins in the urine, which will directly harm the prostate and lead to related prostate diseases. Because the prostate is close to the anorectal part, and often hold stool or constipation, it will lead to too much feces in the rectum, which will compress the prostate, resulting in heavy blood, and increase the risk of prostate hypertrophy.
Third, lack of exercise, often sedentary, people who lack exercise are prone to arteriosclerosis, which will also block the local blood circulation of the prostate. Sedentary will compress a large part of the weight of the upper body on the prostate, resulting in poor blood circulation, which is not conducive to the excretion of prostate fluid and increase the probability of prostate hypertrophy. The two are related. More exercise reduces sitting time.
IV. men often smoke, drink and eat spicy food. These bad living habits will damage the prostate and lead to diseases such as prostate hypertrophy.
V. indulgence in sexual life. Excessive sexual life will lead to congestion of sexual organs, and the prostate will increase due to persistent congestion. Excessive continuous congestion will increase the risk of prostate hypertrophy. And unclean sex life will lead to sexual organ infection, thus reducing resistance. In addition, pay attention to the cleanliness of the prostate, because the scrotum and prepuce are easy to hide dirt, and unclean bacteria may take the opportunity to enter, resulting in prostate disease.
I. respiratory system
Hypertrophy of the prostate is characterized by dyspnea and expectoration of foam like sputum.
II. Immune system
Low function reduces the body's resistance and is prone to infection and tumor.
III. nervous system
Due to the toxic effect of metabolites, patients with prostatic hypertrophy can have limb paresthesia, muscle weakness, irritability, insomnia or drowsiness.
IV. blood system
The kidney not only has the function of generating urine and keeping the internal environment relatively stable, but also can secrete some bioactive substances, such as erythropoietin, renin, hydroxylated vitamin D3 and prostaglandin.
V. digestive system
Gastrointestinal bleeding, halitosis, ammonia, nausea, vomiting and intermittent diarrhea may occur.
Vi. skeletal system
Due to the decrease of hydroxylated vitamin D1 in the body, which affects bone metabolism, patients with prostatic hypertrophy can have systemic bone pain, deformity or fracture.
VII. Skin performance
Due to the decline of renal excretion function and the increase of urea discharged from skin sweat glands, patients with prostatic hypertrophy can have dry skin and desquamation, and white crystalline urea cream appears on the skin surface.
VIII. Uremia
Uremia is characterized by lesions in various systems of the whole body. Due to the decline of the regulatory function of the kidney, a large number of metabolites are not discharged, which can lead to the disorder of water and electrolyte metabolism, acidosis and poison accumulation, which can cause poisoning symptoms and eventually lead to death.
Treatment of prostatic hypertrophy
The harm of benign prostatic hyperplasia lies in the pathophysiological changes caused by lower urinary tract obstruction. There are great individual differences in pathology, and they do not all show progressive development. Some lesions will not develop to a certain extent, so even if there are mild obstructive symptoms, surgery is not necessary.
1. Observation waiting
For mild symptoms, IPSS score below 7 can be observed without treatment.
2. medication
(1)5 α- Reductase inhibitor study found 5 α- Reductase is an important enzyme for the transformation of testosterone to dihydrotestosterone. Dihydrotestosterone plays a certain role in benign prostatic hyperplasia, so 5 α- Reductase inhibitors can inhibit proliferation to some extent.
(2) α- At present, receptor blockers believe that such drugs can improve urodynamic obstruction and reduce resistance to improve symptoms. Commonly used drugs include gottering and so on.
(3) the most widely used antiandrogens are progesterone drugs. It can inhibit androgen cell binding and nuclear uptake, or inhibit 5 α- Reductase interferes with the formation of dihydrotestosterone. Progesterone drugs include megestrone, cyproterone acetate, chlorprogesterone acetate, progesterone caproate, etc. Flubutylamide is a non steroidal anti androgen drug, which can also interfere with the cellular uptake and nuclear binding of androgens. After using antiandrogen drugs for a period of time, the symptoms and urinary flow rate can be improved, the residual urine can be reduced, and the prostate can be reduced. However, after stopping the drugs, the prostate will increase and the symptoms will relapse. In recent years, it has been found that such drugs can aggravate the blood viscosity and increase the incidence of cardiovascular and cerebrovascular embolism. Luteinizing hormone releasing hormone analogues have a highly selective effect on the pituitary gland to release LH and FSH. Long term application can deplete this function of pituitary, reduce the ability of testis to produce testosterone, and even fail to produce testosterone to achieve the effect of drug testosterone removal.
(4) others include M receptor antagonists, plant preparations, traditional Chinese medicine, etc. M receptor antagonist can alleviate detrusor over contraction and reduce bladder sensitivity by blocking bladder M receptor, so as to improve the symptoms of BPH patients during urine storage. Plant preparations such as pushital are suitable for the treatment of BPH and related lower urinary tract symptoms.
In conclusion, the condition should be comprehensively estimated before drug treatment, and the side effects of drugs and the possibility of long-term medication should also be fully considered. Observe the effect of drug therapy, long-term follow-up and regular urodynamic examination to avoid delaying the opportunity of operation.
3. surgical treatment
Surgery is still an important treatment for benign prostatic hyperplasia.
The indications of operation are: ① there are symptoms of lower urinary tract obstruction, the urodynamics has changed significantly, or the residual urine is more than 60m; ② Severe unstable bladder symptoms; ③ It has caused upper urinary tract obstruction and renal function damage; * acute urinary retention, urinary tract infection and gross hematuria occurred on many occasions. ⑤ Complicated with bladder stones. For patients with long-term urinary tract obstruction, whose renal function has been obviously impaired, severe urinary tract infection or acute urinary retention have occurred, they should first indwelling catheter to relieve obstruction, * be controlled after infection, and then undergo surgery after renal function recovery. If it is difficult to insert the catheter or the catheterization time is long, which has caused urethritis, the suprapubic bladder puncture and fistula can be changed. The indications of emergency prostatectomy should be strictly mastered.
4. Minimally invasive treatment
(1) transurethral electrovaporization of prostate
It is mainly the innovation of electrode metal materials, which makes its biological thermal effect different from the former. Due to the rapid thermal transformation, it can produce a high temperature of 400 ℃, which can quickly cause tissue vaporization or coagulative necrosis. Its hemostatic characteristics are extremely significant. Therefore, the clinical application shows that: ① the indication is increased: glands above 60g can be used. ② Clear operation field: due to the remarkable hemostatic effect and clear flushing fluid, it is convenient for operation. ③ Reduction of operation time: due to the reduction of hemostatic steps, the surgical resection is accelerated and the operation time is shortened. ④ Reduction of complications: it is not easy to produce water poisoning (thick coagulation layer), clear operation field, reduce accidental injury, and it is not easy to produce sphincter and capsule injury. ⑤ Rapid postoperative recovery: shorter flushing time.
(2) transurethral plasma bipolar resection of prostate and transurethral plasma enucleation of prostate
Transurethral prostatectomy was performed using a plasma bipolar electrotomy system and in a surgical manner similar to unipolar TURP.
(3) cryotherapy
It can make the prostate tissue necrosis and decay after deep hypothermic freezing, so as to achieve the purpose of frozen prostatectomy. It can be performed through urethra. The operation is simple. It is suitable for patients who are old and can not tolerate other operations. According to the literature, the symptoms of lower urinary tract obstruction in most patients can be relieved or improved, and the residual urine can be reduced. However, cryotherapy has certain blindness, and the depth and breadth of cryotherapy are not easy to grasp. After freezing, transurethral prostatectomy is performed to remove the residual hyperplastic tissue after freezing, which can significantly reduce bleeding.
(4) microwave treatment
The system uses the principle of microwave thermal coagulation of biological tissue to achieve the purpose of treatment. The placement of microwave emitter can be located by rectal ultrasound or transurethral endoscopy. The latter can accurately avoid the external urethral sphincter and reduce the complications of urinary incontinence.
(5) laser treatment
Using laser thermal effect to coagulate, vaporize or remove prostate tissue, the method is similar to transurethral operation. There are surface irradiation, insertion hyperthermia and laser beam resection of glands. The curative effect is certain that the glands are enucleated by laser and the tissues are crushed and sucked out from the bladder. The long-term curative effect and price performance ratio need to be observed.
(6) radiofrequency ablation
The local thermal effect produced by RF wave causes coagulative necrosis of prostate tissue.