Benign prostate disease Flashcards
What is benign prostatic hyperplasia
Proliferation of epithelial and smooth muscle cells in the transition zone which surrounds the urethra.
What are the symptoms of BPH
Bladder outlet obstruction
weak strea
hesitancy
urgency, nocturne
incomplete emptying
terminal dribbling
How do you treat BPH
5 alpha-reductase inhibitors
alpha blockers
tadalafil
surgery
How do you diagnose BPH
DRE & symptoms**
cystoscopy
transrectal US
urodynamics
What causes urinary outflow obstruction with BPH
lumen of the prostatic urethra narrowing and lengthening
What does increased bladder emptying lead to
stasis
*predisposing them to stone formation/infection
What can prolonged urinary tract obstruction lead to
hydronephrosis
compromised renal function
What lower urinary tract symptoms generally progress with BPH
urinary frequency
urgency
nocturia
hesitancy
intermittency
What causes an increase in frequency, urgency, and nocturia with BPH
incomplete emptying and subsequent rapid refilling of bladder
What is urinary retention
sudden, complete retention with marked abdominal discomfort and bladder distention
What causes urinary retention
prolonged attempts to postpone voiding
immobilization
exposure to cold
use of anesthetics, anticholinergics, sympathomimetics, opioids, or alcohol.
What urology symptom score is associated with mild symptoms
1-7
What urologic score is indicative of severe symptoms
20-35
What will the prostate feel like on DRE with BPH
enlarged, contender, rubbery, lost median furrow
What may firm or hard areas in a prostate indicate
prostate cancer
What PSA level requires further workup and evaluation
a 3x jump from normal
*even if within normal range
What is a normal PSA level
0-4
What is the first step in testing if PSA levels indicate it
multi parametric MRI
What is the first attempt at relieving someones urinary retention
standard urinary catheter placement
*second step is coude tip
What are the BPH treatments
behavior modification: decrease caffeine
alpha blockers
5 alpha reductase inhibitors
PDE5i
What is the first line medical management for BPH
Alpha blockers
What are surgical options for BPH
TURP
prostatectomy
PVP
PVEP
What is the standard surgery to treat BPH
transurethral resection of prostate (TURP)
What is urethritis and what is the most common organism
Infection of the urethra
Gonorrhea / trachomatis
