Benign Prostatic Hyperplasia Flashcards
What is BPH?
Benign enlargement of the prostate gland
Who does BPO usually occur in?
Older men (60 per cent of men over 60)
What are the 2 types of BPH?
Static and Dynamic
What is static obstruction?
Glandular overgrowth
What is dynamic obstruction?
Smooth muscle hyperplasia
What is BPH caused by?
Disordered regulation of dihydrotestosterone
What does BPH result in?
- Bladder outflow obstruction
* Benign prostatic obstruction
How does BPH present?
- Poor flow
- Hesitancy
- Termina dribbling
- Incomplete emptying
- Frequency
- Urgency
- Nocturia
How is BPH diagnosed?
DRE: smooth, symmetrically enlarged prostate gland
Abdomen: palpable bladder due to urinary retention
What needs to be excluded with BPH?
Prostate cancer
Infection
How would you exclude prostate cancer?
Test for PSA
How would you exclude infection?
Urine dipstick
What are some possible complications of BPH?
- Urinary tract infection
- Retention
- Obstructive uropathy
- Erectile dysfunction
- Strictures
What is the management of BPH?
Alpha-1 antagonists
5 alpha-reductase inhibitors
What Alpha-1 antagonists can be used to treat BPH?
Tamsulosin
Alfuzosin
How do Alpha-1 antagonists work?
Decrease smooth muscle tone (prostate and bladder)
What are some side-effects of Alpha-1 antagonists?
Dizziness
Postural hypotension
Dry mouth
Depression
Which 5 alpha-reductase inhibitors can be used to treat BPH?
Finasteride
How do 5 alpha-reductase inhibitors work?
Block the conversion of testosterone to dihydrotestosterone (DHT)
What are some adverse effects of 5 alpha-reductase inhibitors?
Erectile dysfunction
Reduced libido
Ejaculation problems
Gynaecomastia
How long do you need to take finasteride before there are results?
Up to 6 months
What would you do if the symptoms of BPH were severe?
TURP
