Looking at the wisdom of Donguibogam through the lens of modern medicine reveals striking parallels. The urinary difficulties discussed here are closely linked to benign prostatic hyperplasia. The prostate gland is a walnut-sized organ present only in men, situated directly below the urinary bladder and encircling the urethra. It performs the vital function of producing and discharging part of the semen.
The difficulty begins when the prostate gland gradually enlarges with age. This growth usually starts around the 40s; by the 60s, more than half of men have histological benign prostatic hyperplasia, and by the 80s, nearly all men are affected. The primary reason for this enlargement is an androgen imbalance. Specifically, the androgen testosterone converts into an active hormone called dihydrotestosterone, which promotes prostate cell proliferation. Where Donguibogam described a decline in kidney essence qi and deficient energy, modern medicine describes age-related shifts in hormonal balance and subsequent cell proliferation.
As the prostate gland enlarges, it compresses the urethra, producing various urinary symptoms:
1. Nocturia, or waking frequently at night to urinate: Waking two or more times during sleep to use the bathroom disrupts rest and markedly reduces quality of life.
2. Sensation of residual urine, or feeling incomplete relief after voiding: An uncomfortable sensation that urine remains in the urinary bladder creates an urge to use the bathroom again shortly after.
3. Weak stream, where the flow is thin and feeble, and urinary hesitancy, where urine does not flow right away: The once-strong stream gradually loses its force.
4. Urinary urgency, or difficulty holding urine: A sudden, pressing urge to urinate that is difficult to postpone, sometimes leading to leakage before reaching the bathroom.
These symptoms are more than everyday annoyances. If neglected, they can progress to urinary bladder hypofunction, urinary tract infection, bladder stone, and in severe instances, kidney damage. The ancient concept that water qi fails to circulate and becomes obstructed corresponds precisely to urethral obstruction and urinary bladder dysfunction caused by prostate enlargement.
Diagnosis involves a digital rectal examination, prostate-specific antigen test, uroflowmetry, post-void residual measurement, and ultrasound when indicated. Modern medicine relies on such objective data to assess the underlying state and progression of the condition, employing medications or surgical procedures when necessary to improve quality of life. Alongside medical care, supporting the body's fundamental balance remains an essential part of long-term wellness.
