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In the early stage of benign prostatic hyperplasia, due to compensation, the symptoms are atypical. With the aggravation of lower urinary tract obstruction, the symptoms are gradually obvious. The clinical symptoms include urinary storage symptoms, micturition symptoms and post micturition symptoms. Due to the slow progress of the disease, it is difficult to determine the onset time.
1. Symptoms during urine storage
The main symptoms of this period include frequent urination, urgency, urinary incontinence and increased nocturia.
* (1) frequent urination, increased nocturia, frequent urine frequency, increased nocturia, but not much urine volume. Chronic detrusor after bladder detrusor compensation, chronic urinary retention, bladder effective capacity and urinary clearance time are shortened. If bladder stones or infections occur, urinary frequency will become more obvious and accompanied by urination.
(2) In case of urinary tract obstruction under urgency and incontinence, 50% ~ 80% of patients have urgency or urgent urinary incontinence.
2. Urination symptoms
The symptoms include hesitation, dysuria and intermittent urination.
With the increase of glands, mechanical obstruction and dysuria aggravated. The degree of lower urinary tract obstruction was not directly proportional to the size of glands. Due to the increase of urethral resistance, the onset of micturition is delayed, the micturition time is prolonged, the range is not far, and the urinary line is thin and weak. The urine is forked and there is a feeling of endless urination. If the obstruction worsens further, the patient must increase abdominal pressure to help urinate. Breathing increases or decreases abdominal pressure, and urinary flow is interrupted and dripping.
3. Symptoms after urination
Symptoms in this period include incomplete urination, dripping after urination, etc.
Incomplete urine and increased residual urine: residual urine is the result of decompensation of bladder detrusor. When the residual urine volume is large, the bladder expands excessively and the pressure is high, which is higher than the urethral resistance, the urine will overflow from the urethra, which is called overflow urinary incontinence. Some patients usually have little residual urine, but when they catch cold, drink, hold back *, take drugs or cause sympathetic stimulation, they can suddenly develop acute urinary retention. Symptoms of urinary retention can be * good and sometimes bad. Some patients can be * acute urinary retention as the first symptom.
4. Other symptoms
* (1) hematuria, congestion of blood vessels on the prostate and blood vessels, dilation of small vessels and enlargement of the glands or friction with the bladder. When the bladder contracts, it can cause microscopic or gross hematuria. It is one of the common causes of hematuria in elderly men. Cystoscopy, metal catheter catheterization, and sudden urinary retention during catheterization are all likely to cause severe hematuria.
* (2) urinary tract infection, urinary retention often leads to urinary tract infections, which may include symptoms such as urgency, frequent urination, dysuria and accompanied by urination. When secondary urinary tract infection occurs, fever, low back pain and systemic symptoms may occur. Usually, although there is no symptoms of urinary tract infection, there may be more white blood cells in urine, or bacteria growth in urine culture.
(3) Bladder stones lower urinary tract obstruction, especially when there is residual urine, the retention time of urine in the bladder is prolonged, which can gradually form stones. When accompanied by bladder stones, there can be urinary line interruption, pain at the end of urination, urination after changing body position, etc.
(4) Renal function damage is mostly caused by ureteral reflux and hydronephrosis. The main complaints of patients are often loss of appetite, anemia, elevated blood pressure, or drowsiness and lack of consciousness. Therefore, benign prostatic hyperplasia should be eliminated first for the symptoms of unexplained renal insufficiency in male elderly people.
(5) For long-term lower urinary tract obstruction, there may be lower abdominal mass caused by filling of bladder diverticulum or upper abdominal mass caused by hydronephrosis. Long term relying on increasing abdominal pressure to help urinate may cause hernia, hemorrhoids and anal prolapse.
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