The road to prostate health

90% of common prostate complaints (including chronic prostatitis, which is common in young adults, and benign prostatic hyperplasia, which is common in middle-aged people) do not require the so-called "magic cure". The core solution is "daily controllable lifestyle adjustment + layered medical intervention that matches symptoms." Even for prostate cancer, the 5-year survival rate of early screening and early treatment can be close to 100%.

Last week, I just received a 32-year-old Internet backend in my clinic. He came in with a stack of "prostate cancer precursors" information from Baidu. When he sat down, the first thing he said was, "Doctor, am I going to die? In the past half month, I have frequent and urgent urination, and I also have occasional pain in my lower abdomen." I checked his prostate fluid and found a plus sign for white blood cells. The lecithin body index was still sufficient. I didn’t prescribe any medicine, so I gave him three requirements: stand up and walk for 2 minutes every 40 minutes, take a sitz bath with warm water for 10 minutes every day, and don’t touch iced American style or spicy hot pot in the past two weeks. I came here for a follow-up checkup this week and all the symptoms have disappeared. I said that I had to sit 12 hours a day for a week to catch up on a project. I didn’t even bother to drink water. I held my urine until I couldn’t stand it anymore before going to the toilet. It was purely my fault.

When it comes to the treatment of prostatitis, there are indeed different treatment ideas in the industry: in the Western medicine system, bacteria and sterility are first distinguished. Bacteria can be solved with antibiotics according to the course of treatment, while sterility is more symptomatic with anti-inflammatory drugs and drugs to relieve smooth muscle tension. The core is to correct the inducements of sitting for a long time, holding urine, and excessive indulgence/abstinence.； In the traditional Chinese medicine system, it is mostly classified as "lead syndrome". Damp-heat syndrome and qi stagnation and blood stasis are the most common syndrome types. Many patients can also get significant relief with sitz bath prescriptions for activating blood circulation and removing blood stasis, and acupoint moxibustion. I have met several patients who had average results from taking western medicine. With the conditioning plan of the Traditional Chinese Medicine Department, their symptoms improved by 70 to 80% in about one month. There is no need to argue about which system is better. The one that suits you is the right one.

Having said this, I have to mention that whenever you have prostate discomfort, you should not rely on "kidney deficiency" and blindly take kidney-tonifying tonics. Last year, there was a 28-year-old young man who had just been married for half a year. He developed frequent urination and thought he had kidney deficiency. He bought more than 3,000 yuan of kidney-tonifying pills and aphrodisiac tea and ate it for less than half a month. However, the frequent urination did not go away. Instead, he began to have painful and yellow urine. When he came for a check-up, his prostate was congested and swollen larger than normal. This is originally caused by the frequent congestion of a new marriage and the heat and humidity caused by sitting for a long time. If you give him supplements, doesn't this mean adding fuel to the fire?

After the age of 45, many men will start to encounter problems such as waking up more at night and thinning of the urine line. This is benign prostatic hyperplasia. There are now different opinions on how to deal with this problem: Conservatives believe that if the symptoms do not affect your life, for example, if you get up 1-2 times a night, you don't need to take medicine. Just adjust your drinking habits and drink less water after 8 pm, and don't drink strong tea or coffee. ； A radical point of view is that if you still have obvious difficulty urinating after taking the medicine for more than 3 months and get up more than 3 times at night, which has affected your sleep and quality of life, you can have minimally invasive surgery as soon as possible. The current holmium laser enucleation surgery has very little trauma, and you can remove the urinary catheter and leave the hospital the next day after the operation. There is no need to carry it. I used to have a 49-year-old university teacher who woke up 4 times a night and had to run to the toilet from time to time during class. He took medicine for half a year but still had no improvement. After surgery, he now wakes up once at most. He said that he could finally sleep through the night. If he had known it was so easy, he would have done it long ago.

Prostate cancer, which everyone is most afraid of, is currently controversial about the threshold for PSA (prostate specific antigen) screening: European and American guidelines recommend starting routine screening after the age of 55, unless there is a family history.； Because the age of onset of prostate cancer has advanced in recent years, domestic guidelines recommend that PSA tests be done every year for those over 50 years old, and those with a family history can do so as early as 45 years old. Don’t worry about who to listen to. If you don’t have any abnormalities in your usual urination and no one in your family has had prostate cancer, it’s absolutely fine to start getting tested at the age of 50. If you have long-term symptoms of prostate hyperplasia and a direct family member has had the disease, there’s no harm in getting tested early. Just don’t be overly anxious.

Many people ask me if I have any tips for taking care of the prostate. To be honest, there are no special effects. Don’t believe those who sell prostate massagers and special-effect cushions worth thousands of dollars. They are really not as effective as standing up to get a glass of water and take two steps after sitting for 40 minutes. ； There is no need to take pumpkin seed oil and lycopene as life-saving medicine every day. You can eat normally, eat more fresh fruits and vegetables, eat less heavy oily and spicy food, and drink less alcohol in a row. This is better than any health supplement. Oh, by the way, some people ask whether you should go for prostate massage regularly. If you don’t have symptoms, there is no need. Regular ejaculation itself can help unclog the prostate, but careless massage may cause injury.

I have been in the Department of Urology for almost 11 years, and I have seen too many cases where small problems turned into serious illnesses, and too many cases where things were dragged on and turned into urinary retention and hydronephrosis. To put it bluntly, the prostate organ is just like the faucet in your home. If you make it every day, break it hard when you twist it, and don't close it tightly after use, it will definitely break easily. ； If you use it gently and check it regularly, if it's really broken, ask a master to repair it, and it will last a lifetime. There is no one-and-done road to health. It's just about eating snacks. If you really have a problem, don't look for folk remedies. It's better to go to a regular hospital to find a doctor.