Definition, etiology and symptoms of benign prostatic hyperplasia (BPH)
**Benign Prostatic Hyperplasia**
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**2.1//What is Benign Prostatic Hyperplasia (BPH)?**
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Benign prostatic hyperplasia (BPH) is the most common disease in urology and is also prevalent among the elderly. It has a significant impact on the health of the elderly, and its incidence increases with age. It can be said that almost 90% of people over 90 years old suffer from this disease.
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> 50% of people over 60 years old have benign prostatic hyperplasia (BPH), and more than 85% of people over 80 years old suffer from BPH.
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Benign prostatic hyperplasia (BPH) is a disease unique to men because women do not have a prostate. Its pathological basis is the hyperplasia and enlargement of prostate tissue, which compresses the urethra and causes difficulty in urination. However, the hyperplasia and enlargement of prostate tissue is not cancer; it is a benign tumor. Its hyperplasia is slow and not unlimited.
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**2.2//What are the causes of prostate hyperplasia?**
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> Causes of benign prostatic hyperplasia: Androgens are sex hormones that maintain male sexual characteristics, and they also play a role in the growth and development of the prostate.
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Normal prostate enlargement or hypertrophy
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> Pathogenesis of prostate disease
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Benign prostatic hyperplasia (BPH) in middle-aged and older adults is closely related to androgens.
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The prostate gland weighs only a few grams at birth. During puberty, due to the large production and release of androgens, the prostate gland begins to grow and develop. By age 20, the prostate gland matures and weighs 20 grams. Around age 45, due to various reasons, including androgen levels, the prostate gland begins to grow slowly again. When the prostate gland grows to the point that it affects our urination, symptoms of benign prostatic hyperplasia (BPH) appear.
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Academician Wu Jieping, a leading urologist in my country, studied eunuchs in the Qing Dynasty and found that none of them had benign prostatic hyperplasia. This also illustrates the role of androgens, but the detailed mechanism of androgen action is still unclear.
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**2.3//How does benign prostatic hyperplasia (BPH) affect our quality of life?**
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Most men generally dislike changing their lifestyles because their established habits are gradually formed based on their experiences, hobbies, work habits, and culture. Changing a lifestyle requires a sufficient reason. Therefore, when men suffer from benign prostatic hyperplasia (BPH), many will not seek medical attention unless the symptoms are obvious and do not affect their lifestyle. They often attribute the symptoms of BPH to old age and organ aging, but this is often not the case. The symptoms are caused by BPH itself. Currently, the consultation rate for BPH in my country is only 30%, indicating a high incidence rate but a low consultation rate, suggesting that knowledge about the prostate is not widespread enough.
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Severe benign prostatic hyperplasia (BPH) greatly affects their lifestyle. Many elderly people with this disease often worry about the availability of restrooms before going to work, traveling, or running errands, and frequent urination disrupts their work rhythm.
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Furthermore, increased nighttime urination makes it difficult for older adults to get a good night's sleep, resulting in less energy the next day.
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Third, they are often worried about having prostate cancer or needing surgery, which makes it difficult for them to maintain their usual lifestyle and leads to bothersome symptoms.
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**2.4//What are the main symptoms of benign prostatic hyperplasia (BPH)?**
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① Intermittent urination: urination is intermittent.
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② Hesitation during urination: When the patient goes to the toilet, they cannot urinate immediately and need to wait for a period of time.
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> ③ Increased nocturia: Blanker et al. reported a significant correlation between nocturia and benign prostatic hyperplasia.
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> ④ Even after urinating, there is still a feeling of needing to urinate.
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> ⑤ A thin urine stream and difficulty urinating are the main symptoms of benign prostatic hyperplasia (BPH).
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> ⑥ End-of-urination dribbling, which is characterized by dribbling of urine just before urination is finished.
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> ⑦ Urinary urgency: This symptom is rare in patients with benign prostatic hyperplasia. It manifests as an inability to control urination, and sometimes, when a toilet cannot be found, the patient wets their pants.