How to treat prostate hyperplasia more effectively?

Men are easily affected by prostate hyperplasia problems. Sometimes, if they are not effectively treated, it will cause great harm to their reproductive health. Therefore, once these symptoms are found, correct countermeasures should be taken, and drug treatment is essential.

1. Watch and wait

For patients with mild symptoms and IPSS score below 7, they can be observed and no treatment is needed.

2. Drug treatment

(1) Studies on 5α-reductase inhibitors have found that 5α-reductase is an important enzyme in the conversion of testosterone to dihydrotestosterone. Dihydrotestosterone plays a certain role in prostate hyperplasia, so the use of 5α-reductase inhibitors can inhibit hyperplasia to a certain extent.

(2) α-receptor blockers: It is currently believed that this type of drug can improve urinary tract dynamic obstruction, reduce resistance and thus improve symptoms. Commonly used drugs include chlorpromazine.

(3) The most widely used anti-androgen drugs are progesterone drugs. It can inhibit the cellular binding and nuclear uptake of androgens, or inhibit 5α-reductase and interfere with the formation of dihydrotestosterone. Progesterone drugs include megestrol acetate, cyproterone acetate, chlormadinone acetate, and progesterone caproate. Flubutamide is a nonsteroidal antiandrogen that can also interfere with the cellular uptake and nuclear binding of androgens. After using anti-androgen drugs for a period of time, symptoms and urine flow rate can be improved, residual urine can be reduced, and the prostate can be shrunk. However, after stopping the drugs, the prostate can enlarge again and symptoms can recur. In recent years, it has been found that such drugs can increase blood viscosity and increase the incidence of cardiovascular and cerebrovascular embolism. Luteinizing hormone-releasing hormone analogs have a highly selective effect on the pituitary gland, causing it to release LH and FSH. Long-term use can exhaust this function of the pituitary gland, reduce the ability of the testicles to produce testosterone, or even make it impossible to produce testosterone, thus achieving the effect of drug removal of testosterone.

(4) Others include M receptor antagonists, herbal preparations, traditional Chinese medicine, etc. M receptor antagonists block bladder M receptors, relieve excessive detrusor contraction, and reduce bladder sensitivity, thereby improving storage symptoms in BPH patients. Herbal preparations such as Prostanolide are suitable for the treatment of BPH and related lower urinary tract symptoms.

To sum up, a comprehensive assessment of the condition should be made before drug treatment, and the side effects of the drugs and the possibility of long-term use should also be fully considered. The efficacy of the drugs should be observed over a long period of time and urodynamic examinations should be performed regularly to avoid delaying surgery.

3. Surgical treatment

Surgery remains an important treatment for prostate hyperplasia.

The indications for surgery are: ① symptoms of lower urinary tract obstruction, obvious changes in urodynamic examination, or residual urine of more than 60 ml; ② severe symptoms of unstable bladder; ③ upper urinary tract obstruction and renal function damage; ④ multiple episodes of acute urinary retention, urinary tract infection, and macroscopic hematuria; ⑤ concurrent bladder stones. For patients with long-term urinary tract obstruction, obvious renal damage, severe urinary tract infection or acute urinary retention, a urinary catheter should be placed to relieve the obstruction, and surgery should be performed after the infection is controlled and renal function is restored. If inserting the catheter is difficult or the long intubation time has caused urethritis, suprapubic cystostomy can be performed instead. The indications for emergency prostatectomy should be strictly controlled.