Under what circumstances should benign prostatic hyperplasia be treated?

Patient's question:

These past few days, I've been experiencing frequent urination and urgency while using the restroom. I've previously had prostatitis. Could you please tell me under what circumstances treatment is necessary for benign prostatic hyperplasia (BPH)?

Doctor's answer:

1. Mild hypertrophy does not require treatment.
2. Estrogen therapy: Oral ethinyl estradiol 1–3 mg once daily, three times a day, for 1–3 weeks. For acute urinary retention or more severe urinary difficulties, the initial dose may be slightly higher, or estradiol valerate 10 mg can be given intramuscularly every 5–7 days.
3. During acute urinary retention, acupuncture can be applied to points such as Guanyuan, Qihai, Sanyinjiao, and Yanglingquan. Catheterization should be performed to eliminate urinary retention, and the catheter should be retained to gradually empty the bladder.
4. Surgical treatment: If the prostate hyperplasia is significant, there is chronic urinary retention, a large amount of residual urine (60–100 mL or more), urinary tract infection, impaired renal function, and the condition does not improve with the aforementioned treatments, prostatectomy is recommended.

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