Benign Prostatic Hyperplasia Flashcards
What is Benign Prostatic Hyperplasia characterised by
Fibromuscular and Glandular Hyperplasia
Benign Prostatic Hyperplasia predominantly affects
Transition Zone
50% of men with Benign Prostate Hyperplasia have
Mod to Severe LUTS
Benign Prostatic Hyperplasia may result in
Bladder outflow Obstruction
International Prostate Score Mild
0-7
International Prostate Score Moderate
8-19
International Prostate Score Severe
> 20
Assessing LUTS: What is associated with Voiding (Obstructive)
Hesistancy
Poor Stream
Terminal Dribble
Incomplete Empty
Assessing LUTS: What is associated with Storage (Irritative)
Frequency
Nocturia
Urgency
Incotinence
Investigations for Prostate Disease
MSSU
Flow Rate Study
Post Void Bladder Residual USS
PSA Bloods
If there is Haematuria in urine what test
Flexible Cytoscopy
If PSA raised or abnormal DRE what test
TRUS guided Prostate Biopsy
Medical Treatment of Uncomplicated BPO
Alpha Blockers
5 Alpha Reductase Inhibitors (Finasteride or Dutasteride)
Name 2 - 5 Alpha Reductase Inhibitors
Finasteride
Dutasteride
Surgical Intervention of Uncomplicated BPO if Prostate <100
TURP if Prostate <100
Surgical Intervention of Uncomplicated BPO if Prostate >100
Open Retropubic or Transversical Prostatectomy
Main Treatment for LUTS due to BPO
Alpha Blockers
Smooth muscle of bladder neck and prostate innervated by
sympathetic alpha-adrenergic nerves
sympathetic alpha-adrenergic nerves are mostly what type
alpha 1a subtype
Alpha blockers cause what to bladder
smooth muscle relaxation and antagonise the ‘dynamic’ element to prostatic obstruction
5a reductase inhibitors converts what to dihydrotestosterone
testosterone
What drug reduces prostate size and risk of progression of BPE but only if >25cc prostate
5a reductase inhibitors
Gold Standard Surgical for BPE
TURP
Complications of BOO
Progression of LUTS Acute Retention Chronic retention Urinary Incontinence Bladder Stone
Treatment of Complicated BOO
Medical
Cystiolithopaxy and TURP when BPO and Stones
Long Term Catheter
