Prostatic enlargement ≠ prostatic hyperplasia? The cause is understood and treated aggressively

Prostatic hyperplasia is a geriatric disease, common in men over 50 years old, the incidence can increase with age, mainly manifested as increased frequency of urination, urgency, difficulty urinating, increased nocturia, incomplete urination, etc.

Does a large prostate necessarily mean prostatic hyperplasia?

The answer is no. Prostatic hyperplasia is a pathological concept, and the main feature is the prostate stroma and prostate gland component hyperplasia, in other words, there are more cells that make up the prostate, and the hyperplasia is shown under the microscope, which does not cause changes in the volume of the prostate. Some prostate diseases, such as acute prostatitis, can cause congestion and edema of the prostate tissue, and the results of digital rectal examination or ultrasound examination show that the prostate is swollen and enlarged, which is not an increase in prostate cells, so it is not prostatic hyperplasia. Because there are large differences between each person, and the size of the prostate is also different, it needs to be comprehensively evaluated according to age, impact on the body, whether there are other diseases, etc., and it cannot be considered that a large prostate volume must be prostatic hyperplasia. Especially in men, if the ultrasound examination shows a large prostate during the physical examination, it is mistaken for prostatic hyperplasia, which can cause tension and anxiety, which can affect life.

What factors are associated with prostatic hyperplasia?

1. Sex hormones and their receptors

Through the male hormone receptor of prostate cells, male hormones will directly act on prostate cells, affecting the growth, proliferation and apoptosis of the cells, so prostatic hyperplasia is related to the proportion of male hormones, the expression of male hormones, and the number of sex hormone receptors.

2. Inflammatory factors

Chronic inflammation in the prostate tissue, especially if it lasts for a long time, stimulates and maintains prostatic stromal and epithelial hyperplasia.

3. Prostatic stromal gland epithelial function

The prostatic stroma interacts with epithelial cells and relies on the extracellular matrix and growth factors. In general, the growth factors and extracellular matrix in the prostate maintain a dynamic balance, and as long as there is an imbalance, it may induce prostatic hyperplasia.

4. The role of growth factor neurotransmitters

Benign prostatic hyperplasia tissue contains a large number of growth factors, which promote or inhibit the proliferation of prostate cells in different ways, which in turn affects the size of the prostate.

5. Imbalance between cell proliferation and apoptosis

The dynamic balance between cell proliferation and apoptosis determines the size of the prostate, and once there is an imbalance between cell proliferation and apoptosis, the prostate size is abnormal.

Tips

Benign prostatic hyperplasia usually requires observation and waiting, and re-examination every 6 months; Under the guidance of a doctor, medication treatment, such as a receptor blocker, 5a reductase inhibitor, M receptor antagonist, etc.Surgery should also be considered when moderate to severe prostatic hyperplasia, especially lower urinary tract symptoms, has seriously affected the quality of life, the response to drug therapy is not satisfactory, or urinary retention occurs more than once.