How to treat prostatic hyperplasia and difficulty urinating

Difficulty urinating caused by prostatic hyperplasia can be treated by adjusting lifestyle, medication, physical therapy, minimally invasive surgery, open surgery, etc. Prostatic hyperplasia may be related to factors such as age and changes in androgen levels, and usually manifests as symptoms such as frequent urination, urgency, and increased nocturia.

1. Adjust your lifestyle

Limit fluid intake, especially at night before bed, and avoid diuretic substances such as caffeine and alcohol. Maintain regular urination habits, do not hold in your urine, and try double urination to empty your bladder when urinating. Moderate exercise can help improve pelvic floor muscle function, but you need to avoid activities that put pressure on the prostate, such as sitting for long periods of time or riding a bicycle.

2. Drug treatment

Alpha-blockers such as tamsulosin hydrochloride sustained-release capsules can relax the smooth muscles of the bladder neck and prostate and improve urinary symptoms. 5α-reductase inhibitors such as finasteride tablets can reduce the size of the prostate and require long-term use to be effective. If combined with infection, antibiotics such as Levofloxacin tablets can be used. In case of urinary retention, Terazosin Hydrochloride Tablets can be used for a short period of time to relieve symptoms.

3. Physical therapy

Transurethral microwave thermotherapy promotes necrosis and shrinkage of prostate tissue through local heating. Transurethral acupuncture ablation uses radiofrequency energy to precisely ablate hyperplastic tissue. These minimally invasive methods are suitable for patients who are ineffective in drug treatment but do not want surgery. They require multiple treatments and have a limited duration of effect.

4. Minimally invasive surgery

Transurethral resection of the prostate is the current gold standard, which removes obstructed prostate tissue through an electrical resection loop. Transurethral enucleation of the prostate can remove hyperplastic glands more thoroughly and is suitable for larger prostates. Laser surgery such as holmium laser or green laser vaporization results in less bleeding and faster recovery, but requires high equipment.

5. Open surgery

Suprapubic prostatectomy is suitable for severe hyperplasia cases with glands exceeding 80ml. Transperineal prostatectomy is suitable for patients with bladder stones, but the risk of postoperative urinary incontinence is high. These two traditional surgical techniques are relatively invasive and have been gradually replaced by minimally invasive techniques.

Daily care should be taken to keep the perineum clean and dry and avoid spicy and irritating foods. Moderate levator exercises can be performed to strengthen the pelvic floor muscles, but in case of acute urinary retention, you should seek immediate medical catheterization. Regularly review prostate-specific antigen and urinary flow rate to monitor disease progression. Keep warm in winter to prevent colds from aggravating symptoms, and empty your bladder before traveling for a long time. If abnormalities such as hematuria and fever occur, you should seek medical attention promptly to adjust the treatment plan.