Causes, symptoms, and underlying reasons for discomfort associated with benign prostatic hyperplasia (BPH).

What are the causes of benign prostatic hyperplasia (BPH)?

The medical community recognizes the following as causes of benign prostatic hyperplasia (BPH):

(1) Excessive sexual activity and masturbation cause congestion of the sexual organs, and the prostate tissue enlarges due to prolonged blood stasis.

(2) Chronic inflammation of the prostate is not completely cured, such as urethritis, cystitis, seminal colliculitis, etc., which causes congestion and hyperplasia of the prostate tissue.

(3) Frequent alcohol abuse or long-term drinking, and a fondness for spicy and other irritating foods can stimulate prostate hyperplasia.

(4) Lack of physical exercise can lead to arteriosclerosis and poor local blood circulation in the prostate, which can also cause this disease.

What are the symptoms of benign prostatic hyperplasia (BPH)?

(1) Frequent urination: The number of urinations increases significantly, both during the day and at night, especially the number of nighttime urinations, which affects the patient's sleep.

(2) Difficulty urinating: It takes a while to urinate while standing next to the urinal, i.e. urinary hesitancy. In normal individuals, urine is expelled within 2 seconds of starting urination, but in patients with benign prostatic hyperplasia, the initial urine output is significantly delayed.

(3) Weak urination: refers to the disappearance of the force of the urine flow during urination, the "range" is shortened, it cannot form a parabola, and it appears "weak and powerless", sometimes even dripping.

(4) Urine stream splitting: When a normal person urinates, the urine stream is concentrated into a jet of water that "pours down", while in people with benign prostatic hyperplasia, the urine stream is often split into two streams due to the compression of the urethra.

(5) Interrupted urination: Urine cannot be discharged all at once, but must be discharged in several segments. That is, urinate for a while, pause slightly, and then urinate again.

(6) Incomplete urination: After urinating, there is always a feeling of "not being able to urinate completely", and urine will drip out, often causing wet pants.

(7) Urinary incontinence: A large amount of urine accumulates in the bladder, causing the pressure in the bladder to gradually increase, and it will overflow spontaneously when the abdominal pressure increases, such as when coughing or straining.

The reasons why benign prostatic hyperplasia (BPH) causes discomfort

The prostate gland consists of the urethral glands surrounding the urethra and the prostatic glands surrounding the urethral glands. It can be divided into three groups: ① urethral gland group; ② suburethral gland group; ③ prostatic gland group. In a normal prostate, the prostatic gland group occupies most of the outer ring, while the other two groups occupy a very small central area. Therefore, the prostate can be divided into inner and outer layers: the inner layer consists of the urethral gland group and the suburethral gland group, and the outer layer is the prostatic gland group, with a fibrous membrane between these two layers. Benign prostatic hyperplasia (BPH) mainly occurs in the inner layer, surrounding the urethra (the posterior urethra from the bladder neck to the verumontanum), the urethral gland group and the suburethral gland group, as well as connective tissue. Smooth muscle tissue gradually proliferates, compressing and surrounding the outer prostatic gland group to form a "shell-like capsule," approximately 2-5 mm thick. The capsule has a clear boundary with the hyperplastic glands and is easily bluntly dissected. Generally, the lesions can be classified into three types: unilobal hyperplasia; bilateral lobular hyperplasia; and trilobal hyperplasia (both lobes and the middle lobe).

The discomfort caused by benign prostatic hyperplasia (BPH) is mainly due to the enlarged glands compressing the bladder neck and posterior urethra, resulting in urinary tract obstruction. Obstruction can lead to a series of functional disorders and damage to the urethra, bladder, and kidneys. The degree of BPH and the severity of urinary tract obstruction are not necessarily proportional; it mainly depends on the degree of compression of the posterior urethra by the enlarged portion. Sometimes, even a small enlarged portion can cause severe obstruction. For example, in cases of median lobe enlargement, the bladder base is elevated and may protrude into the bladder, acting as a valve during urination and blocking the internal urethral opening, preventing the bladder from emptying. In cases of bilateral lobes enlargement, the posterior urethra is often compressed and elongated, causing curvature of the prostatic urethra and resulting in urinary obstruction.