Clinical manifestations of benign prostatic hyperplasia

The symptoms of benign prostatic hyperplasia can be divided into two categories is due to hyperplasia of prostate obstruction resulting from obstruction of urinary tract symptoms; The other is a result of complications caused by urinary tract obstruction.

1, obstructive symptoms of benign prostatic hyperplasia was mainly due to urinary tract obstruction. Bladder neck caused by oppression, but also includes its own to overcome the obstruction of the bladder have a response.

① frequent urination is an early signal of benign prostatic hyperplasia, in particular nocturnal increase in the number of more clinical significance. In general, the frequency of the number of nocturnal often parallel the degree of benign prostatic hyperplasia. The original Night of the elderly can not afford to appear at night 1 or 2 times of urination, and often reflect the advent of early obstruction, and development from the 2nd night to night 4 to 5 times or even more, describes the development and increase the lesion.

② inability to urinate, urine and urine thin line drops Lek. Because of the obstructive prostatic hyperplasia, urination in patients with the use of greater force to overcome resistance, as well as voiding effort; hyperplasia of prostate urethral pressure will be deflated to urine thin line; As the disease progresses, there may also be interrupted voiding, post-voiding not drop Lek symptoms.

③ hematuria.

④ retention. Advanced prostatic hyperplasia in patients with severe, severe obstruction may be cold, drinking, or too much time憋尿causes infection can not be discharged urine and acute urinary retention.

2, obstruction of the main complications of infection, hydronephrosis, such as uremia.

① infection is not as easy to open the river pollution, the urinary bladder neck obstruction is easy to combined acute urinary tract infection, showing a surge in the number of nocturia, urgency,尿痛, such as hematuria and fever.

② severe benign prostatic hyperplasia hydronephrosis, after a long time, due to compensatory bladder and upper urinary tract dysfunction, ureter and renal pelvis can lead to stagnant water, stagnant water can be severe abdominal palpable "mass" - Swell kidney; bladder filling the abdomen may be the next touch "mass" - the bladder swell.

③ uremia-induced development of hydronephrosis in patients with benign prostatic hyperplasia, as the real pressure on the kidneys, can cause renal failure - uremia. Show loss of appetite, nausea, vomiting, anemia and so on. Such symptoms as a result of relatively subtle at first, the lack of specific, easily overlooked or misdiagnosed as gastrointestinal diseases and delay or even until headache, retardation, lethargy and even coma was found that alarming.

④ other: some patients with benign prostatic hyperplasia may be changes in sexual desire or eroticism, sexuality and some low, a small number of patients have Hematospermia.

In addition, because patients with benign prostatic hyperplasia-induced voiding difficulties, increased abdominal pressure, but also can cause or aggravate hemorrhoids, hernia and other diseases.

What is hyperplasia of prostate?

The pathology of benign prostatic hyperplasia and prostate pathological analysis of sub-both inside and outside the two-tier: the inner layer for transurethral resection of the surrounding mucosa and submucosal glands; outer body for the prostate. The latter constitutes the main body of the prostate, between two layers separated by fiber membrane. Doctor of benign prostatic hyperplasia occurs mainly in the inner layer in the bladder neck to the urethra after a period of fine Fu interstitial gland, the part now known as the microscope can be seen as a transition zone. Mild interstitial gland hyperplasia, proliferation of connective tissue structure and smooth muscle-based, as well as increased gland capsule, tubular epithelial hyperplasia to papillary intracavitary was prominent, and the formation of mesenchymal mixed adenoid organizations nodule. Mesenchymal and adenoidectomy in accordance with the proportion of different organizations, and more cases of benign prostatic hyperplasia is divided into two types, large and soft nodules fibromuscular gland and gland-type small and hard fibromuscular hyperplasia of the external compression of the prostate so that the outer body gradually become a thin layer of fibrous pseudocapsule adenoid. With hyperplasia of their boundaries can be significantly easier since major surgery nodule membrane extraction system it is also known as clinical surgical capsule gene

Hyperplasia of the prostate so that the occurrence of bladder neck obstruction, bladder neck in order to overcome resistance and to strengthen the detrusor contraction occurs so that compensatory hypertrophy was trabecular processes. Cavity increased bladder pressure and bladder mucosa may be weak since the inter-band expanding outward from the Agency to form a diverticulum of bladder neck obstruction. Continue to increase, urine will be varying degrees of residual in the bladder, accompanied by an increase in residual urine, bladder wall thinning gradually so that the lower end of the ureter through the bladder wall oblique muscle by the formation of the role of physiological valve failure. The bladder urine will reflux and renal pelvis and ureter, caused by stagnant water on both sides of the upper urinary tract, renal pelvis increased pressure to ischemic renal atrophy, renal dysfunction caused by uremia eventually occur.

Prostate diagnosis and treatment of cysts?

Some of the causes of prostatic cyst in patients with suspected prostatitis do B-inspection, the doctor sometimes found in prostate cyst. Faced with such a result, some patients are very worried, not sure how prostate cyst is going on? 1. Prostate cyst is large, the reasons for the formation of the prostate gland as a result of congenital or acquired reasons of the formation of cystoid changes. (1) true prostatic cyst: prostate gland during embryonic development by in the barriers, causing the prostate duct stenosis, causing obstruction, content retention gradually formed, it belongs to retention cysts of the prostate. (2) Congenital cysts: catheter for kidney with renal dysplasia next possession, part of the expansion of the lumen and the formation of cysts. From the next tube in the renal cysts often located in the middle of the prostate after, the sky from the catheter in the renal cysts were living on both sides. This cyst is not starting at the prostate, bladder wall and adhesion often. Its size can grow to very often, oppression dysuria caused by bladder neck; oppression坠胀anus rectum caused by a sense of the difficulties with defecation. There is often accompanied by congenital prostatic cyst hypospadias, cryptorchidism, renal agenesis and other congenital diseases. (3) acquired cyst: by tenacious lead to acinar prostate stromal incomplete or intermittent obstruction, gradually thickened alveolar epithelium and, in the final occurrence of retention cyst can be located in any part of the prostate or bladder neck to highlight Department, a diameter of 1-2 cm. (4) inflammatory cyst: Department of connective tissue caused by chronic inflammation of prostate hyperplasia, prostate catheter resulted in narrow, secretion retention cyst formation. (5) parasitic cyst: as a result of parasitic, such as prostate can Hydatid around pipes and chronic inflammation, or granulation hyperplasia, cyst shape. To the above cyst retention cyst of the prostate most common, can occur in any part of gland. 2. Prostatic cyst by pathological changes in cyst biopsy shows alveolar cyst formed by the normal, or for more room and columnar epithelium-lined acini, and some lower cubic epithelium, capsules filled with serous or bloody serous liquid. 3. Prostatic cyst prostatic cyst symptoms and diagnosis can be complicated by infection and calculus, the larger the cyst when the growth pressure to the urethra or bladder neck, the delay will enable the flow. Common symptoms of urgency, frequent urination, urinary energy, urinary fine lines, such as dysuria and urinary retention; pressure to the rectum may cause difficulties in defecation. Cyst larger prostate digital rectal examination in the Department of touch cyst urethrography shows that there arc posterior urethral pressure trace, ultrasound and CT can clearly identify its location. 4. The treatment of prostate cyst and asymptomatic small cysts, the general secondary infection, such as long as they do not, do not have treatment, but attention should be paid to the dynamic changes can be observed. Large cysts or cysts can be symptoms of a small surgery. It has been reported in B-positioning Transperineal or under transrectal cyst aspiration line, and then into the coagulant, but not entirely due to an acinar or intermittent obstruction, and even if more than aspiration, but because of local gland secretion, is still easy to cyst recurrence.

Prostate cyst What cause?

Prostatitis patients with suspected B-inspection done, doctors are sometimes found in the prostate in the cyst. Faced with such a result, some patients are very worried, not sure how prostate cyst is going on? 1. Prostate cyst is large, the reasons for the formation of the prostate gland as a result of congenital or acquired reasons of the formation of cystoid changes. (1) true prostatic cyst: prostate gland during embryonic development by in the barriers, causing the prostate duct stenosis, causing obstruction, content retention gradually formed, it belongs to retention cysts of the prostate. (2) Congenital cysts: catheter for kidney with renal dysplasia next possession, part of the expansion of the lumen and the formation of cysts. From the next tube in the renal cysts often located in the middle of the prostate after, the sky from the catheter in the renal cysts were living on both sides. This cyst is not starting from the actual prostate, bladder wall and adhesion often. Its size can grow to very often, oppression dysuria caused by bladder neck; oppression caused rectal anal坠胀sense difficulties with defecation. There is often accompanied by congenital prostatic cyst hypospadias, cryptorchidism, renal agenesis and other congenital diseases. (3) acquired cyst: by tenacious lead to acinar prostate stromal incomplete or intermittent obstruction, gradually thickened alveolar epithelium and, in the final occurrence of retention cyst can be located in any part of the prostate or bladder neck to highlight Department, a diameter of 1-2 cm. (4) inflammatory cyst: Department of connective tissue caused by chronic inflammation of prostate hyperplasia, prostate catheter resulted in narrow, secretion retention cyst formation. (5) parasitic cyst: as a result of parasitic, such as prostate can Hydatid around pipes and chronic inflammation, or granulation hyperplasia, cyst shape. To the above cyst retention cyst of the prostate most common, can occur in any part of gland. 2. Prostatic cyst by pathological changes in cyst biopsy shows alveolar cyst formed by the normal, or for more room and columnar epithelium-lined acini, and some lower cubic epithelium, capsules filled with serous or bloody serous liquid. 3. Prostatic cyst prostatic cyst symptoms and diagnosis can be complicated by infection and calculus, the larger the cyst when the growth pressure to the urethra or bladder neck, the delay will enable the flow. Common symptoms of urgency, frequent urination, urinary energy, urinary fine lines, such as dysuria and urinary retention; pressure to the rectum may cause difficulties in defecation. Cyst larger prostate digital rectal examination in the Department of touch cyst urethrography shows that there arc posterior urethral pressure trace, ultrasound and CT can clearly identify its location. 4. The treatment of prostate cyst and asymptomatic small cysts, the general secondary infection, such as long as they do not, do not have treatment, but attention should be paid to the dynamic changes can be observed. Large cysts or cysts can be symptoms of a small surgery. It has been reported in B-positioning Transperineal or under transrectal cyst aspiration line, and then into the coagulant, but not entirely due to an acinar or intermittent obstruction, and even if more than aspiration, but because of local gland secretion, is still easy to cyst recurrence.

Bone metastasis of prostate cancer combined treatment

The incidence of prostate cancer in men in the United States ranked first, second only to lung cancer for the second cancer cause of death. In our country, along with changes in the structure of people's diet and the extension of average life expectancy in recent years, the incidence of prostate cancer has been an upward trend. Because the symptoms of prostate cancer similar to benign prostatic hyperplasia, the incidence of occult, and its symptoms are often ignored, when the time of diagnosis, about 7 0% have local invasion or distant metastasis (including bone metastases). Prostate cancer bone metastases is the most common symptom of bone metastases in different parts of the degree of pain, clinically effective treatment for their little. Clinical diagnosis of prostate cancer is usually a clear implementation of castration and anti-androgen treatment, bone metastases secondary to multiple sites of pain associated with lesions of the cases, the use of continuing to take anti-androgen drugs at the same time, with sr treatment of radionuclide (irradiation) and some lesions radiation therapy (external beam radiotherapy) combined with surgical treatment of the combination therapy.

Anti-androgen therapy in the early stages of androgen receptor-positive cancer cells due to the lack of androgen stimulation and apoptosis, tumor volume can be gradually reduced; with treatment, and partial androgen receptor-positive cells gradually differentiated into a hung hormone receptor-negative cells. At this point, the anti-androgen therapy decreased the effects of the emergence of difficult to control the primary lesion of prostate cancer and bone metastases development in patients with this part, we continue to take anti-androgen drugs, based on the use of radionuclides increases sr with radiation therapy for bone metastases larger lesions of bone metastases with external radiation therapy combined with surgical treatment of the combination therapy. sr is a bone metastasis of radionuclides, it is the main use of its launch of pure B-ray (half-life of 5 0. 5 d) for bone tumors with radiation therapy, intravenous injection into the human body the main concentration in the bone metastases osteoclastic foci or areas of osteoblast response to launch anti-cancer radiotherapy to reduce the disease and even disappear, so as to achieve the purpose of pain, and normal bone tissue to absorb very little sr. After the application of sr, bone metastases have a temporary local hyperemia, edema response to increased pressure on local nerves, so that some patients a temporary increase of bone pain, pain that is blinking phenomenon, generally 3 ~ 5d to be local reactions after sr subsided and after treatment appear gradually, the pain began to reduce, or even disappear. Bone metastasis of prostate cancer as a result of a number of regular positions, extensive transfer, the application of radiotherapy is limited, and the radionuclide can be achieved within the radiation therapy treatment at the same time more than the effect of lesions and satisfactory; but a one or 2 large transfer of weight-bearing bone lesions, radiation therapy nuclides would be difficult to achieve the desired results, so when supplemented by external radiation therapy can make up for its shortcomings.

Reported in the literature abroad for prostate cancer pain caused by bone metastases, sr inside and outside the radiation therapy radiotherapy for pain relief rates were 80% and 68%.