Prostatic hyperplasia, also known as prostate enlargement, is also short for benign prostatic hyperplasia. It is a common disease in middle-aged and older men, with a high incidence in men over 50 years of age. The cause of the disease is mainly related to the interaction between androgens and estrogens, and the most common symptom is abnormal urination. Prostate hyperplasia may also affect the sexual function of the patients.
Prostate enlargement itself does not directly affect sexual function, but lower urinary tract symptoms (LUTS) caused by it may affect sexual function. Therefore, let's first understand what lower urinary tract symptoms are.
Lower urinary tract symptoms are the main symptoms of BPH and include these:
Frequent Urination: Urinating more than eight times a day;
Urinary Urgency: Sudden feeling of a strong desire to urinate;
Urinary Incontinence: Inability to control urination
Frequent Urination at Night: The need to get up more than twice a night to urinate;
Urination Difficulty: Needing to wait or push to start urinating;
Weak Urine Flow: Weak or thin urine stream;
Intermittent Urination: Pauses or segments during urination;
Incomplete Urination: A residual sensation that remains after voiding;
Urinary Dribbling: A small amount of urine still dribbling out after urination;
These symptoms can affect the male quality of life and mental health and may even lead to some complications.
So, how do lower urinary tract symptoms affect male sexual function? There are several main areas:
Affect Libido. LUTS can affect the male mental state and emotional state, making them feel anxious, depressed, low self-esteem, or frustrated, which in turn reduces their libido.
Affect Erection. LUTS affects blood circulation and nerve conduction in men, leading to under-congestion or flaccidity of the corpus cavernosum of the penis, resulting in erectile dysfunction (ED). The incidence of ED increases with the severity of LUTS, and about 30%-80% of patients with BPH also suffer from ED.
Affect Ejaculation. LUTS affects the function of the urethral sphincter and prostate in men, leading to ejaculatory abnormalities such as weak ejaculation, painful ejaculation, and retrograde ejaculation. Retrograde ejaculation is when semen enters the bladder instead of exiting the body. This condition is not life-threatening but can affect fertility and sexual satisfaction.
Therefore, if BPH patients have sexual dysfunction, they should seek timely medical treatment and seek appropriate treatment. To improve sexual dysfunction, men should treat the lower urinary tract symptoms caused by BPH, together with taking some drugs to enhance sexual function.
The three main types of treatment for BPH are medication, surgery, and minimally invasive treatment. The specific method depends on the patient's age, health condition, prostate size, severity of symptoms, complications, and personal preference.
Generally speaking, if the symptoms are mild and do not affect the quality of life, patients can choose to observe and wait, regularly review, adjust, and pay attention to the lifestyle to improve the symptoms, such as avoiding drinking too much water and too much alcohol, consuming spicy and stimulating foods. Patients can choose drug treatment if the symptoms are moderate, affecting the quality of life.
Commonly used drugs are in the following categories:
Alpha-blockers: These drugs relax the smooth muscles of the prostate and bladder neck, reducing urinary resistance and improving urination difficulties. Commonly used are Cardura, Flomax, Alfuzosin Uroxatral, and Silodosin Rapaflo. These medications usually work faster but may cause side effects such as dizziness, low blood pressure, and retrograde ejaculation.
5α-reductase Inhibitors: These drugs can inhibit the conversion of androgens into the more active dihydrotestosterone (DHT) in the prostate, thus inhibiting the proliferation of prostate cells and reducing the size of the prostate. Commonly used drugs include Proscar and Avodart. These drugs usually need to be taken for a long period to be effective but may cause side effects such as decreased libido, erectile dysfunction, and breast development.
Combination Medication: If a single medication is ineffective or tolerated, an alpha-blocker and a 5-alpha-reductase inhibitor may be considered to achieve better results. A combination drug (Dutasteride) is now available that can easily accomplish this.
Cialis: This is a medication for erectile dysfunction and can also be used to treat BPH. It relaxes the smooth muscles of the prostate and bladder, improves blood circulation, and relieves urination symptoms. It can be used alone or in combination with other medications but may cause side effects such as headache, back pain, and indigestion.
Besides, patients also choose TCM, such as Diuretic and Anti-inflammatory Pill. It can effectively improve the problem of urinary discomfort. Meanwhile, it also has sterilization and anti-inflammation functions, which can improve patients' immunity.
If the symptoms are severe and seriously affect the quality of life, or if medication is not effective or tolerated, or if there are complications, such as urinary retention or renal insufficiency, surgical or minimally invasive treatments may be an option. Prostate extraction (PE), a traditional surgical method, requires skin incision. There are various minimally invasive treatments, such as transurethral resection of the prostate, transurethral incisional of the prostate), etc., and patients can make a reasonable choice based on the doctor's advice and their situation.
To summarize, prostate hyperplasia will have a severe impact on men's lives and may also involve the dignity of men. Therefore, male patients should pay close attention to it and go to regular professional hospitals promptly to avoid other complications and even more unimaginable consequences.