Prevention and treatment strategies for benign prostatic hyperplasia (BPH): hormone medications, microwave surgery, and five lifestyle measures.

(1) Prevention of Benign Prostatic Hyperplasia (BPH) ① Eat more light and easily digestible foods, more vegetables, and prevent constipation, as dry stools can aggravate urination difficulties. ② Eat less spicy, pungent, and stimulating foods, and abstain from alcohol to reduce the chance of prostate congestion. ③ Try to ride a bicycle less, as the bicycle seat compresses the prostate area in the upper urethra, reducing bladder emptying capacity and aggravating the condition. ④ Maintain a cheerful mood, avoid worry and anger, and avoid excessive sexual activity. ⑤ Treat diseases of the urogenital system, such as thoroughly treating prostatitis and inflammation of the posterior urethra near the prostate, to actively prevent urinary retention. (2) Treatment of Benign Prostatic Hyperplasia (BPH) ① Hormone therapy ● Estrogen therapy. Diethylstilbestrol, 2-3 mg each time, 3 times a day, orally, for 30 days as one course of treatment. Adverse reactions include nausea, vomiting, loss of appetite, and breast swelling and pain. Adding vitamin B₆ can alleviate the above symptoms. ● Androgen therapy. For those who do not respond well to estrogen therapy, androgen therapy can be considered, which can increase the contractility of the detrusor muscle. Testosterone propionate, 25 mg intramuscularly, twice a week, 20 times as one course of treatment. ● Combined use of androgens and estrogens. Methyltestosterone 5 mg plus diethylstilbestrol 2 mg, three times daily, taken concurrently. ● Adrenocortical hormone therapy. Prednisone, etc. The hormone therapies mentioned above have many adverse reactions, making it difficult for patients to adhere to, and are now rarely used. ② Other drug treatments. Currently commonly used drugs mainly include: drugs that shrink the prostate, such as finasteride (Proscar), serneton, pyrantel, and prostate-specific drugs; drugs that reduce bladder outlet tension, such as chlorpheniramine, terazosin (Gortzine), and tamsulosin. ③ Special treatments ● Transurethral balloon catheter prostate dilation. A special balloon catheter is inserted into the prostatic urethra through the urethra, and fluid is injected into the balloon to reach 3 atmospheres to dilate the prostatic urethra and relieve urinary difficulties. The short-term effect rate is good in 80% of cases. ● Local injection. 20% mannitol or a mixture of carbolic acid, glacial acetic acid, and glycerin is injected into the prostate via the perineum or rectum, 2.5–3 ml each time, once every 7 days, with effects seen after 2–5 treatments. ● A shape memory alloy mesh stent is placed in the prostatic urethra. ● Cryotherapy. This involves freezing the prostate at deep low temperatures, causing tissue necrosis and sloughing, achieving the goal of cryoablation of the prostate. ● Microwave therapy. This utilizes the principle of thermal coagulation of biological tissues by microwaves to achieve therapeutic purposes. ④ Surgical treatment. Currently, surgical treatment remains the most effective treatment for benign prostatic hyperplasia (BPH). Surgery aims to remove the hyperplastic prostatic tissue and relieve bladder outlet obstruction; it does not actually remove the entire prostate, but rather the hyperplastic prostatic tissue.

Surgical treatment of benign prostatic hyperplasia (BPH): (1) Transurethral resection of the prostate (TURP): The prostate is "spun" away without an incision. The procedure uses a small tube called a rectoscope to pass through the urethra and remove the hyperplastic tissue with electric shock, thus widening the urethra. This surgery is not perfect, and its sequelae include impotence (5%–10%) and urinary incontinence (1%). TURP requires a recovery period of 4–6 weeks. (2) Transurethral prostatectomy: It is very similar to TURP, except that instead of removing the excess prostate, the prostate is cut into one or two pieces to relieve pressure on the urethra. Its effect is similar to TURP, but with fewer adverse reactions. However, this surgery is less effective for very enlarged prostates. (3) Laser surgery: The excess prostate tissue is burned off with a laser. The surgery can be performed outside the body. The surgery is bloodless, with almost no risk of impotence, urinary incontinence, or weak ejaculation, and recovery takes only one day. Its short-term efficacy is similar to that of prostatectomy. However, because this treatment method is relatively new, there are no long-term follow-up records, and it is still in the exploratory stage.

Five measures to avoid benign prostatic hyperplasia (BPH): (1) Avoid drinking alcohol before bed: Not only alcohol, but also all liquids before bed. Alcohol and liquids can relax all the muscles in the body, including the bladder. (2) Avoid stimulating drinks: At any time of day, avoid drinks that stimulate the bladder to prevent the feeling that the bladder is always full. Some people think that drinking acidic drinks, such as orange juice and carbonated drinks like soda, is fine, but these drinks are also stimulating. (3) Avoid spicy foods: Spicy foods containing ingredients such as red chili peppers can also irritate the bladder, so avoid them. (4) Avoid antihistamines: These drugs can also cause bladder relaxation and narrowing of the bladder neck, which allows urine to flow. The bladder becomes fuller and the outlet becomes narrower, making urination more difficult. (5) Wait a while: About 30% of untreated people later find that their symptoms improve on their own. The bladder is a muscle, and over time it can strengthen to squeeze out urine with greater force.