Post Date December, 02 2023
Doctors generally divide the prostatic hyperplasia into three degrees through the digital examination of the anus. Some doctors also describe the degree of prostatic hyperplasia in another way: the normal prostate is chestnut large, the first degree of hypertrophy is pigeon egg large, the second degree of hypertrophy is egg large, and the third degree of hypertrophy is goose egg large. The grading of prostatic hyperplasia can only explain the extent of prostate enlargement, but not the extent of the obstruction of the hyperplasia gland to the urethra and the severity of the disease.
According to the anatomical position, the prostate is divided into five lobes: anterior, posterior, left, right and middle. The proximal end is the inner gland around the urethra, and the outer one is the outer gland. In the normal prostate, the outer gland occupies the majority of the prostate, while the inner gland is in the smallest part of the center. However, the situation is different when the current columnar glands proliferate.
If the hyperplasia mainly occurs in the inner layer of the prostate, and the inner gland tightly surrounds the urethra, it is very easy to flatten the urethra even if it is slightly enlarged, causing difficulty in urination.
This is because it is still difficult to find prostatic hypertrophy even through digital examination of the anus. The external gland may grow laterally, and sometimes it grows very large, even to the third degree, but it does not oppress the urethra, so there may be no symptoms of urethral obstruction or mild symptoms. Obviously, the grading of BPH can only indicate the size of the prostate gland, but not the severity of the disease.
In order to show the severity of the disease in patients with BPH, doctors have divided BPH into three stages:
In the first stage, the patient had difficulty urinating, frequent urination, increased nocturia, weakness urination, and trabeculae in the bladder wall due to laborious urination, but there was no residual urine;
The second stage refers to the incomplete compensation of the urinary muscle of the bladder wall, which can not completely eliminate the urine and lead to residual urine, often accompanied by chronic bacterial cystitis;
The third stage refers to the decline of bladder emptying function, urinary retention and renal insufficiency caused by long-term urination.
If judged according to the results of urine flow rate measurement, the maximum and average urine flow rate of patients in the first stage were not significantly reduced, and the urine flow pattern was mostly within the normal range; The maximum and average urine flow rate of the patients in the second stage were significantly decreased, the urination time was significantly prolonged, and the urine flow pattern showed a multi-wave curve; The maximum urine flow rate of patients in the third or late stage was further reduced, and the urination time was longer, and the urine flow pattern was mostly low and flat.
The stage of BPH has certain significance in deciding the treatment plan. It is generally believed that the first stage of BPH is suitable for conservative treatment, and the early stage of the second stage of BPH may also be suitable for conservative treatment. The second stage of patients with poor effect of conservative treatment, or the development of the disease, as well as the third stage of BPH, should consider surgical treatment.
In a word, the patients with BPH should not only be satisfied with the size of the prostate by the doctor through the digital rectal examination, but should judge the clinical stage of the disease by combining the severity of their own dysuria symptoms and the results of the urine flow rate examination. If necessary, they should also be supplemented by prostate B-ultrasound, nephrogram and blood urea nitrogen examination. In particular, patients with symptoms who have only once enlarged or even small prostate in rectal digital examination should not be taken lightly because they are not seriously ill, so as not to delay the favorable time of treatment!
