benign prostate hyperplasia

Question 1

what is benign prostate hyperplasia?

Answer 1

• increase in size of prostate gland with no malignancy
• normal with ageing

Question 2

what are the risk factors for benign prostate hyperplasia?

Answer 2

• increasing age
• ethnicity - afro Caribbean- increased testosterone
  -family history
• diabetes
• heart disease
• obesity

Question 3

what is protective to benign prostate hyperplasia?

Answer 3

castration

Question 4

what is the pathology behind benign prostate hyperplasia?

Answer 4

• inner transition zone of prostate proliferates and narrows urethra

Question 5

what are the symptoms of benign prostate hyperplasia?

Answer 5

• LUTS
• storage symptoms
• voiding symptoms
• if there is a totally occluded urethra- retention, hydronephrosis, UTI, stones

Question 6

what are LUTS storage symptoms?

Answer 6

• frequency
• urgency
• nocturia
• incontinence
  (FUNI)

Question 7

what are voiding LUTS symptoms?

Answer 7

• poor stream
• dribbling
• incomplete emptying
• straining
• dysuria

WISE
W- WEAK STREAM
I-INTERMITTENCY/ HESITNANCY
S- STRAINING
E- EMPTYING INCOMPLETE

Question 8

how is benign prostate hyperplasia diagnosed?

Answer 8

1. DRE ( rectal exam )
   - smooth and enlarged
2. PSA
   - rule out prostate cancer
3. urine test

Question 9

what is the treatment for benign prostate hyperplasia?

Answer 9

1. lifestyle- decrease caffeine
   - may need catheter acutely
2. drugs
3. surgery - last resort
   - TURP- transurethral resection of prostate

Question 10

what is the first line of drugs used for BPH? what does it do?

Answer 10

Alpha blocker- tamsulosin
- relaxes bladder neck

Question 11

what is the second line of drugs used for BPH? what does it do?

Answer 11

5 alpha reductase inhibitors - finasteride
- decrease testosterone production and therefore decrease prostate size