Prostate Diseases

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), an enlargement of the prostate gland, is a common condition in middle-aged and older men.[1] The incidence of BPH increases with age.[2] While the presence of an enlarged prostate doesn’t always lead to clinical symptoms, for many, urinary difficulties increase as they get older. The incidence appears to be higher in urban than in rural areas, and there are also racial differences that may affect the degree of enlargement.[3]

The exact cause of BPH is still not fully understood, despite extensive research. It’s thought to result from a disruption in the balance between the growth of epithelial and stromal cells and cell death (apoptosis). Several factors are believed to be involved, including androgens and their interaction with estrogens, interactions between the prostatic stroma and glandular epithelial cells, growth factors, inflammatory cells, neurotransmitters, and genetic factors. What is currently known is that functioning testicles and advancing age are two necessary conditions for BPH to develop. More recently, factors such as smoking, obesity, alcohol consumption, family history, race, and geographical environment have also been noted for their potential connection to the development of BPH.

BPH is a frequent ailment among older men, with symptoms arising from the gradual enlargement of the prostate gland, which puts pressure on the urethra and bladder outlet.[1] Clinically, this manifests as frequent urination, urgency, increased nighttime urination, and difficulty in urinating. It can lead to complications like urinary tract infections, bladder stones, and blood in the urine, all of which can seriously impact the quality of life for older men.[1] Therefore, active treatment is necessary, and in some cases, surgery may be required. BPH can be seen as a sign of aging in the prostate, and its high incidence can lead to sexual dysfunction, male infertility, and the serious risk of urinary retention. Experts advise that recognizing the common symptoms of BPH and seeking timely treatment is crucial.

From a Traditional Chinese Medicine (TCM) perspective, the causes of BPH are mainly attributed to: insufficient central qi, overexertion, improper diet, deficiency of kidney essence, lung heat with qi stagnation, downward flow of damp-heat, liver qi stagnation, and urinary tract obstruction.[4][5]

Prostatitis

Prostatitis is a prostate condition caused by a variety of complex factors, primarily characterized by urinary irritation and chronic pelvic pain. It is a common urological disease and the most frequent one in men under 50. Despite its high incidence, the cause of prostatitis, especially the non-bacterial type, is not well understood. Therefore, treatment mainly focuses on alleviating symptoms.

In 1995, the U.S. National Institutes of Health (NIH) established a new classification for prostatitis:

• Type I: Acute bacterial prostatitis.

• Type II: Chronic bacterial prostatitis.[6]

• Type III: Chronic prostatitis/chronic pelvic pain syndrome.[6]

• Type IV: Asymptomatic inflammatory prostatitis.[6]

Non-bacterial prostatitis is far more common than the bacterial form.

• Type I prostatitis often has a sudden onset, with systemic symptoms like chills, fever, and fatigue, accompanied by pain in the perineum and above the pubic bone.[7] Patients may experience urinary frequency, urgency, and rectal irritation, and in some cases, acute urinary retention.[7]

• Type II and III prostatitis have similar clinical symptoms, often involving pain and urinary abnormalities. Regardless of the type, chronic prostatitis can present with a similar set of symptoms, collectively known as the prostatitis syndrome, which includes pelvic pain, urinary problems, and sexual dysfunction. The pelvic pain can be complex, typically located above the pubic bone, in the lumbosacral region, and the perineum. The pain can radiate to the urethra, spermatic cord, testicles, groin, and the inner abdomen, sometimes mimicking an acute abdominal condition or renal colic, which can lead to misdiagnosis. Urinary abnormalities include frequency, urgency, painful urination, difficulty urinating, a forked stream, dribbling after urination, increased nighttime urination, and a milky white discharge from the urethra after urination or bowel movements. Sexual dysfunction may occasionally occur, including decreased libido, premature ejaculation, painful ejaculation, weakened erections, and impotence.

• Type IV prostatitis presents with no clinical symptoms and is usually discovered incidentally during examinations for other prostate-related issues.[6]

Daily Health Care Tips

1. Adhere to treatment. Do not arbitrarily change medications or treatment methods during the course of therapy. Symptom relief often takes time, with initial treatment needing to be maintained for at least two weeks, and some infections requiring 8 to 12 weeks. Randomly switching medications can easily lead to a disruption of the bacterial balance or the development of drug resistance, resulting in incomplete treatment.

2. Maintain a regular sex life. It’s advisable not to withhold ejaculation. Avoid frequent masturbation and unsafe sexual practices.

3. Have a correct understanding of prostatitis. Maintain a positive mindset and reduce psychological stress to avoid exaggerating symptoms, which can lead to dizziness, memory loss, anxiety, suspicion, and insomnia.

4. Stay hydrated and urinate regularly. Drink plenty of water and urinate frequently. Keep your bowels regular. Hot sitz baths or applying a hot water bottle to the perineum can be beneficial.

5. Avoid smoking and alcohol. Do not consume spicy or irritating foods.

6. Avoid prolonged sitting. Refrain from long periods of cycling. Engage in regular physical exercise, with a preference for jogging and lower body exercises, while avoiding strenuous activities.