Prostate Health Standards

There are no uncomfortable symptoms that affect life, there are no pathological abnormalities in imaging and laboratory tests, and urinary and reproductive functions are not affected. If the three conditions are met at the same time, it belongs to the category of health. There is no need to stick to various rigid values ​​​​circulated on the Internet.

To put it bluntly, the prostate is like a soft rubber ring hooping the upper reaches of the urethra. As long as the ring is not swollen, hard, or stuck in the urethra, there is no abnormal pain when pressed, and it normally opens and closes smoothly, then it is good. There is no need to use a ruler to measure whether it exactly meets the standard size of 4×3×2cm spread online. Last week, I met a 29-year-old operating man in the outpatient clinic. He stayed up three nights in a row to catch up on a project. The physical examination report showed prostate calcification. Ultrasound showed that the size of the prostate was 4.2×3.1×2.3cm, which was a bit larger than the standard reported online. He was so scared that he searched Baidu all night and even searched for "Will prostate removal affect fertility?" His hands were shaking when he sat across from me. I asked him for a long time and found that his urination was completely normal. He had never had frequent urination, urgency or pain in urination. He also had no perineal swelling or groin pain. His sexual life was not affected. I also checked that the prostate specific antigen (PSA) was only 1.2ng/ml, which is far lower than the critical value of 4ng/ml. I just asked him to go back and do what he should do without prescribing any medicine.

What many people don’t know is that the size of the prostate varies greatly among individuals, just like people’s heights vary. Not everyone is stuck in the same value. Especially for men after the age of 50, physiological hyperplasia occurs with age, which is a very normal degenerative change. As long as there is no thinning of the urine line, difficulty in urination, more than two nocturias that affect sleep, and the residual urine test is less than 10ml, even if the size is a little larger than the standard value, no intervention is needed at all, and it is considered a healthy state. Many informal institutions use the names of "prostate enlargement" and "prostate calcification" to fool people into doing useless physical therapy. They spend a lot of money, but in fact it is not necessary at all.

Regarding the judgment criteria, different systems have different perspectives. In addition to looking at symptoms, Western medicine will also combine the results of digital rectal examination, PSA, and urinary tract ultrasound: during digital examination, the prostate texture is flexible, no hardness, and no obvious tenderness, the PSA value is stable within a reasonable range, and there are no abnormal nodules or abscesses on ultrasound, so there is basically no problem. Interestingly, there is a misunderstanding that has been circulating for a long time, that is, the number of white blood cells in the prostatic fluid is regarded as the gold standard for judging health. Many doctors did judge this way in the past few years, but now the latest "China Prostatitis Diagnosis and Treatment Guidelines" have made it clear that if there are no symptoms, even if the white blood cell count is higher, it is normal, and no special intervention is needed. There is no need to rush to take antibiotics when you see high white blood cells.

If we switch to the judgment logic of traditional Chinese medicine, we will be more biased towards the overall condition. For example, whether there will be frequent white dripping after urination, whether there will be long-term soreness and weakness in the waist and knees, and whether there will be moisture in the scrotum, and whether there will even be repeated anxiety and irritability due to prostate-related discomfort. These are all references for whether to adjust. There is no right or wrong between the two standards. It just depends on whether you prefer to solve local problems or make overall adjustments.

The most common situation encountered in outpatient clinics is that people mistake normal physiological reactions for pathological changes. For example, drinking two large cups of hot milk tea in winter and running to the toilet twice an hour are completely normal metabolic reactions and do not count as frequent urination. ； Also, the perineum was a little swollen after sitting for a long afternoon, but it was relieved after standing up and walking for ten minutes. It was not a prostate problem, it was just local pressure and poor blood circulation, so don't be nervous. I have been practicing urology clinic for almost 10 years, and at least 90% of the people who say they have "unhealthy prostate" are actually scaring themselves, either by comparing the fragmented information on the Internet, or by being deceived by messy advertisements.

If you really have pain during urination, swollen perineum, or sudden increase in nocturia for more than a week, go to a regular hospital to call a urology department. It costs more than ten yuan, which is much more reliable than searching Baidu for half a night. There is no need to buy those "prostate care" health care products that cost hundreds of dollars. Staying up less late at night, not sitting still for three or four hours in a row, and holding back your urine less often will be more effective than any other health care product.