Benign prostatic diseases Flashcards
What is BPE?
Benign prostatic enlargement (BPE)- large prostate gland
Define Benign prostastic hyperplasia.
(BPH)- appearance under microscope enlargement
What is BPO?
Benign prostatic obstruction (BPO)- symptoms associate with large prostate gland that is causing compression
What is bladder outflow obstruction?
Bladder outflow obstruction (BOO)- prostate and bladder neck causing outflow obstrution
Explain what BPH is and where it is found?
It is fibromuscular and glandular hyperplasia, mostly within the transition and central zone of the prostate. It is very common.
What scoring system is used in the assessment of BPH?
The international prostate symptom score. This is used to assess how worried the patient is about their symptoms and the impact it is having on their quality of life.
How do alpha blockers work?
They are the main treatment of LUTS due to BPO, they cause relaxation of the bladder neck and antagonise the prostate alpha receptors. Tamsulosin is the most commonly used one as it is highly selective to the prostatic alpha receptors so does not cause a drop in BP which most others would.
What are some side effects of the use of Alpha blockers in BPO?
If not Tamsulosin then can cause BP drop and they can all cause retrograde ejactulation, so sperm travels in to bladder due to bladder neck relaxation.
How do 5 alpha reductase inhibitors work?
They inhibit the conversion of testosterone to dihydrotestosterone. Dihydrotestosterone is the active form and causes growth, so inhibiting their formation causes reduction in prostate size and can reduce the risk of growth.
These can take up to 6 months to work and are not as effective as alpha blockers at reducing symptoms.
When is surgery (TURP or ablation ) indicated?
Progression of symptoms, acute or chronic urinary retention, urinary incontinence, UTI, bladder stone or renal failure.
