Prostate hypertrophy and can’t urinate, man accidentally “falls” through his bladder! Diet, Habits, Drugs, and Surgery to Fight Prostate Hypertrophy

Text / Today Health Hong Suqing

A man in his 60s was sent to the hospital with abdominal pain after a fall at home. The doctor found that the man fell through the bladder. It turned out that the man was suffering from hypertrophy of the prostate.

On the day of the incident, he could not urinate all the time, and the retention of urine caused the bladder to swell. It was like a full balloon, and it was extremely fragile. It will cause the bladder to burst as soon as it hits!

Dr. Li Zhiqiao from the Department of Urology of Mackay Hospital, who treated the patient, pointed out that because the man’s bladder ruptured and the urine overflowed the abdominal cavity, causing peritonitis, the situation was very critical. Antibiotic treatment, fortunately out of danger after two weeks.

Physicians remind that patients with mild to moderate prostate hypertrophy can reduce their symptoms through dietary adjustments or combined medication. 

In the event of repeated urinary tract infections, frequent hematuria, bladder stones, bladder diverticulum, or the occurrence of “unable to urinate” and the need to rely on catheterization to discharge urine and other complications, it is recommended to consider surgical treatment. Otherwise, it may not only affect kidney function, but even lead to fatal crisis if you are not careful.

Waiting for you one day? Treatment options for mild, moderate, and severe prostate hypertrophy vary widely

Dr. Li Zhiqiao pointed out that the prostate is a gland unique to men. It is located at the opening of the bladder and surrounds the urethra. Its function is to secrete prostate fluid to help sperm motility and constitute a part of semen.

Before the age of 40, the average male prostate is only about 20 grams in size. As the age increases, the prostate will gradually proliferate and hypertrophy. As a result, some people begin to experience related urination symptoms.

International Prostate Symptom Scale (IPSS) to assess symptom severity

The size of the prostate is not necessarily proportional to the clinical symptoms. Therefore, the treatment strategy for patients with benign prostatic hypertrophy mainly depends on the clinical symptoms of the patient.

Dr. Li Zhiqiao pointed out that doctors will use the “International Prostate Symptom Scale”, urination diary, urine flow rate examination, etc., to first understand the severity of the patient’s symptoms and the degree of impact on the quality of life.

The “International Prostate Symptom Score” is based on the seven common symptoms of the patients themselves: nocturia, frequent urination, urgent urination (unable to hold back), unclean urination, intermittent urination, or urination that requires effort , or the voiding inability score. Finally, add the degree to which the patient’s own perception of these symptoms affects the quality of life! According to the score, it is divided into light, moderate and severe.

At the same time, the doctor will use prostate ultrasound and digital rectal examination to determine the size of the prostate and whether there is a tumor, plus urine test and blood drawing to confirm whether the patient has infection, hematuria and prostate specific antigen (PSA) level.

Mild prostate hypertrophy. Changes in lifestyle and eating habits may reduce symptoms

Generally speaking, patients with mild prostate hypertrophy do not even need to take medicine. By changing their lifestyle and eating habits, they can live in peace with prostate hypertrophy.

As for how to adjust your eating habits? Dr. Li Zhiqiao said, for example, usually drink water slowly, do not drink too much at one time, 300C.C. for one hour, but try not to drink water two hours before going to bed. Cut down on diuretic foods (tea, coffee, fruit, etc.) after dinner. When you usually have the urge to urinate, do not go to the urine immediately, but practice holding back the urine. In principle, urinate once every two hours. Avoid spicy food such as coffee, tea, spicy food, etc.

If these lifestyles and diets can be implemented, it can help mild patients relieve symptoms to a certain extent.

Moderate prostate hypertrophy. Symptomatic medication to reduce symptoms

In addition to changes in lifestyle and eating habits, moderate patients usually need to be controlled with medication. There are two types of drugs commonly used in the treatment of prostate hypertrophy: one is ” alpha-blocker*”, and the other is “5α reductase inhibitor*”.

An alpha blocker works by letting the prostate relax, and when it relaxes, the urethra naturally opens. But this type of drug may also lower blood pressure, and side effects include postural hypotension and dizziness. Patients who are taking antihypertensive drugs should communicate with their cardiologist to adjust the dosage of antihypertensive drugs.

“5α- reductase inhibitor”, which acts as an anti-male hormone, can reduce the size of the prostate by about 20%. But it takes time for the prostate to shrink, so the effects of these drugs need to be taken over a long period of time to gradually emerge. However, because it is anti-male hormone, the side effects are similar to male menopause symptoms, and patients may affect sexual function and cause side effects such as loss of libido after taking the drug.

In addition to the above two common drugs, doctors also use other drugs according to the individual symptoms of patients. For example, some patients urinate five or six times a night, which not only seriously affects sleep, but also affects their relationship with partners. For those with severe nocturia like this, antidiuretic hormones can be used. As for the combination of sexual dysfunction, PDE-5 inhibitors can be used to solve two problems at one time. Overactive bladder medication may also be used if frequent or urgent urination is severe. In short, it is to choose the right medicine for the patient’s symptoms!

Severe prostate enlargement. Involvement of other organs should consider surgical treatment

Dr. Li Zhiqiao pointed out that if the patient with prostate hypertrophy can accept the symptoms related to urination, it does not matter if he does not need surgery. However, there are several conditions that require surgery: for example, chronic unclean urine, urine reflux and damage to kidney function. Or severe hematuria, often blood in the urine. In addition, because the urine is often not clean, too much dirt is deposited, and the bladder has long stones.

 Or frequent urination, bladder diverticulum. or recurrent urinary tract infections. Or patients who do not want to take medicine for a long time, it is recommended to have surgery!

At present, the mainstream surgical method is transurethral prostatectomy. The doctor enters through the urethral opening and scrapes the prostate tissue with electrocautery or laser. There will be no wounds in appearance.

But many patients worry that surgery may lead to impotence, or permanent urinary incontinence? In this regard, he explained, “If the prostate is an orange, the nerve that controls the erection is located on the outer skin of the orange. Since the transurethral curettage of the prostate removes the pulp from the middle, the orange peel remains.

.So this operation does not affect erectile function, except that about 1% may be affected by the heat injury of the erectile nerve during the operation.”

He pointed out that the more common side effect of surgery is temporary urine leakage, but this phenomenon will be relieved about two weeks to one month after the operation and will not last for a long time.

 “This is because the natural barrier around the urethral opening was scraped off, so the urine flow became faster after the operation, and I couldn’t hold it for a while. After I got used to it slowly, the faucet would be turned on again!”

Another common sequelae is retrograde ejaculation. The inevitable retrograde ejaculation is caused by structural changes! But this has no effect on the elderly who do not have children.

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