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renal > benign prostate disease + urinary tract obstruction > Flashcards

benign prostate disease + urinary tract obstruction Flashcards

1
Q

BPE

A

benign prostatic enlargement

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2
Q

BPH

A

benign prostatic hyperplasia

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3
Q

BPO

A

benign prostatic obstruction

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4
Q

BOO

A

bladder outflow obstruction

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5
Q

LUTS

A

lower urinary tract symptoms

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6
Q

benign prostatic hyperplasia

A

fibromuscular and glandular hyperplasia
affects transition zone
part of male ageing

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7
Q

LUTS: voiding (obstruction)

A

hesitancy
poor stream
terminal dribble
incomplete empytin g

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8
Q

LUTS: storage (irritative)

A

frequency
nocturia
urgerny
+/- urge incontinence

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9
Q

physical exam

A

abdnomen - palpable bladder?
penis - external urethral meatal stricture, paraphimosos
DRE - prostate
urinalysis

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10
Q

Ix

A

MSSU
PSA
urea and creatinint
USS

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11
Q

management BPO

A

watchful waiting
medical therapy - alpha blockers, 5 alpha reductase inhibitors
surgical - TURP, prostatecotmy, alblation

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12
Q

alpha blockers

A

main treatment of LUTS due to BPO

cause smooth muscle relaxation and antagonise dynamic element to prostatic obstruction

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13
Q

5-alpha reductase inhibitors

A

converts testosterone to dihydrotestosterone

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14
Q

what do 5-alpha reductase inhibitors do

A

reduce prostate size and risk progression BPE

reduce LUTS

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15
Q

TURP

A

transurethral resection of prostate

gold standard - v effective releiving symptoms

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16
Q

TURP complications

A

bleeding
infection
retrograde ejaculation
stess UI

17
Q

complications of BOO

A 
progression of LUTS
acute urinary retention 
chronic urinary retention 
urinary incontince (overflow) 
UTI 
bladder stone 
renal failure
18
Q

treatment of complicated BOO

A

surgery

long term cathetrisation

19
Q

acute urinary retention

A

painful ability to void with a palpable and percussible bladder

20
Q

acute urinary retention risk factors

A 
BPO
UTI 
urethral stricture
alcohol excess
post-op
21
Q

acute urinary retention immediate treatment

A

catheterisation - urethral or suprapubic

22
Q

chronic urinary retention

A

painless palpable and percussible bladder after voiding

pt able to void but residual volume

23
Q

chronic urinary retention aetiology

A

detrusor underactivity:

  • 1ry: bladder failure
  • 2ry: longstanding BOO
24
Q

chronic urinary retention presentation

A

LUTs
UTI
sotnes
overlfow incontinence

25
Q

chronic urinary retention immediate Mx

A

catheterisation

26
Q

upper urinary tract obstruction presentatoin

A 
pain 
haematuria - frank, micro
palpable mass
infection 
renal failure
27
Q

management of upper tract obstruction

A

IV access
Bloods, ABG, urine and blood cultures
IV fluid and ?antib
analgesia

28
Q

lower urinary tract obstruction presentation

A 
LUTs
acute or chronic u retention 
recurrent UTI 
haematuria
bladder stones 
renal failure

renal (29 decks)

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