New type of prostate surgery solves hidden worries of middle-aged and elderly men

        Prostate hyperplasia is commonly referred to as "benign prostatic hypertrophy (BPH)", and it occurs in middle-aged and elderly men. However, don't underestimate it because it is "benign", and many people's lives are troubled by it. This article will explain to you what discomfort this symptom can cause? How to assess severity? What is the current treatment?

        What problems can an enlarged prostate cause?

        The "prostate" is a male-specific organ located at the exit of the bladder, surrounding the upper end of the urethra. With age, the prostate is stimulated by male hormones for a long time, and the tissue proliferates and enlarges, which in turn compresses the urethra and bladder, causing "lower urinary tract symptoms". Patients often do not realize the problem of an enlarged prostate until symptoms appear.

        The urinary tract system from top to bottom is: kidneys, ureters, bladder and urethra. Among them, kidneys and ureters are "upper urinary tract system", while bladder and urethra are "lower urinary tract system". Symptoms related to the lower urinary tract include: frequent urination (note), nocturia, urgency, dysuria, inability to completely empty urine when going to the toilet, and even acute urinary obstruction.

        Patients with hypertrophic prostate will frequently have the urge to urinate, which is fast and urgent, and must be urinated immediately. In severe cases, urine may even leak. Although some patients are in normal condition during the day, they will keep getting up to go to the toilet at night. When the urine is discharged more than 2 times at night, it is recommended to receive evaluation and treatment. Although there are many causes of nocturia, such as sleep apnea, diabetes, etc., among middle-aged and elderly men, prostate hyperplasia is still the most common problem.

        The enlarged prostate not only compresses the urethra, causing the feeling of urinary obstruction, but also stimulates the bladder, causing "overactive bladder". The need to go to the emergency department for catheterization can also lead to recurrent urinary tract infections or chronic kidney disease in some people.

        How to assess prostate symptoms

        The public can use the "International Prostate Symptom Scale" to self-assess. If the score exceeds 8, it is considered to be moderate or above, and active treatment is recommended. In outpatient clinics, in addition to inquiries and scoring sheets, physicians usually conduct routine urine tests to determine whether hematuria or urinary tract infection is caused. As for the physical examination, digital anal examination is performed to evaluate the size of the prostate and the possibility of developing cancer. However, it is better to use "transrectal ultrasound" to measure the size of the prostate more objectively, and also arrange "urinary tract". Dynamic examination" to determine whether there is obvious voiding disturbance or bladder injury.

        When the disease reaches moderate or severe severity, in addition to giving health education and publicity, doctors will also take more active treatment, which is mainly divided into drugs or surgery. In terms of drug use, they mainly include: "alpha sympathetic nerve blocker" and "5-alpha reductase inhibitor". The former can relax the tight muscles next to the urethra and the bladder outlet, making urination smooth; the latter inhibits male hormones Derivatives, which in turn prevent prostate hyperplasia and reduce the chance of deterioration.

        In addition, for people with combined sexual dysfunction, current medical guidelines and evidence-based medicine recommend the use of long-acting, low-dose "phosphodiesterase type 5 inhibitors", which can improve both sexual function and urination symptoms. If the lower urinary tract symptoms of the patient are mainly overactive bladder such as frequent urination, urgent urination, nocturia, etc., combined treatment with related drugs can be considered to achieve the best effect.

        Even if the urinary tract symptoms continue to worsen after drug treatment, hematuria, recurrent urinary tract inflammation, bladder stones, acute urinary obstruction, impaired renal function, or low compliance with drug therapy, or even due to drug In the event of side effects, surgery may be considered. At present, endoscopic surgery is still the mainstream. The traditional unipolar or bipolar "electrosurgery prostate curettage" uses a urethral endoscope to scrape off the proliferative tissue of the prostate piece by piece to dilate the urethra and relieve the pain. Obstruction; but common side effects such as bleeding, infection, retrograde ejaculation after surgery, and a small number of patients may experience sexual dysfunction, urinary incontinence, and even urethral stricture.

        New Laser Vaporization Surgery and Endoscopic Surgery for Enucleation of Prostate

        In recent years, the technology of laser cauterization and vaporization has made great progress. The new type of laser vaporization or enucleation of prostate endoscopic surgery can use high-energy laser to vaporize or remove excess prostate tissue to achieve treatment. Compared with electrosurgical curettage, the blood loss during the operation is less, which can reduce the infection rate, immediately relieve the symptoms of obstruction, and recover faster. Most patients can remove the catheter 1 to 2 days after the operation. discharged home. Not only that, the new surgery has high safety and low side effects. It is quite mature and suitable for high-risk patients. It is only limited by the framework of health insurance benefits and must be operated at their own expense.

        With the rapid development of science and technology, more treatment and detection methods will be developed in the future, such as: new drugs, the use of lycopene, or the development of new surgeries such as prostate water jets and simple prostate opening devices to relieve the lower urinary tract symptoms, while reducing invasiveness and complications. For patients who are not suitable for surgery and have poor drug effects, prostate vascular embolization should be considered. After evaluation by a urologist, referral to a cardiovascular medicine or radiology department can also achieve certain curative effects.

        Of course, no matter which treatment method is adopted, the patient and the doctor need to discuss in detail and formulate the most suitable plan in order to obtain the best treatment results.

        Note: If you urinate more than 8 times during the day, you often feel the urge to urinate, but the amount of urine may not be much.

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