Benign Prostatic Hyperplasia Flashcards
What is benign prostatic hyperplasia?
This is an increased NUMBER of prostate cells (not size), it is non-cancerous.
What is the average size of the male prostate?
22cc, it increases in size with age.
what is 5-alpha reductase?
5 alpha-reductase is an enzyme in the prostate which converts testosterone into dihydrotestosterone. 5 alpha-reductase increases with age - dihydrotestosterone causes the prostate cells to love for longer and multiply quicker.
What are LUTS?
Lower urinary tract symptoms - common in BPH where theres bladder outflow obstruction:
storage: frequency, nocturia, urge, urge incontinence.
Voiding: hesitancy, poor stream, terminal dribbling, incomplete emptying.
What is BOO?
Bladder outflow obstruction
what are causes of BOO?
Benign prostatic hyperplasia/enlargement, phimosis, bladder cancer, prostate cancer, bladder neck stricture.
where is the most common area of prostate enlargement?
in the transitional zone.
what is the investigations in benign prostatic hyperplasia?
digital rectal examination.
Prostate-specific antigen (is increased in both benign prostatic hyperplasia AND prostate cancer).
what is the treatment of BPH?
finasteride (5 alpha-reductase inhibitor). tamsulosin - alpha blocker, TURP (transurethral resection of prostate).
when is TURP or open prostate resection indicated?
<100cc - TURP, >100cc - open surgery.
What is acute urinary retention?
PAINFUL, percussible and palpable bladder with the inability to urinate.
What is the treatment for acute urinary retention?
Catheterisation and starting an alpha blocker (tamsulosin)
What is chronic urinary retention?
Painless, palpable and percussible bladder after voiding.
what are complications of chronic urinary retention?
Renal failure, overflow incontinence.
what is the treatment of chronic urinary retention?
catheterisation, TURP, clean intermittent self-catheterisation.
