benign prostatic hyperplasia Flashcards
what
hyperplasia of stomal and epithelial cells of prostate
lower urinary tract symptoms
hesitancy weak flow urgency frequency terminal dribble incomplete emptying nocturia
assessment of man presenting with LUTS
DRE abdo exam urinary freequency volume chart urine dipsitx PSA
causes of raised PSA
prostate ca
BPH
prostatitis
UTI
prostate exam: benign prostate
feels smooth, symmetrical, slightly soft
maintained central sulcus
prostate exam: cancerous prostate
may feel firm/hard, assymetrical, craggy, irregular
loss of central sulcsu
Mx - medical options
alpha blockers - relax smooth muscle, symptomatic improvement
5-alpha reductase inhibitors - reduce size of prostate
5-alpha reductase
converts testosterone to dihydrotestosterone (DHT) which is a more potent androgen hormone
mechanism of 5-alpha reductase inhibitors
reduct DHT in tissues (incl prostate) leading to reduction in prostate size
Mx - surgical options
- transurethral resection of prostate (TURP_
- transurethral electrovaporisation of prostate]
alpha blocker side effects
postural hypotension
5-alpha reductase inhiitor side effects
sexual dysfunction
TURP
most common surgical treatment BPH
remove part of prostate from inside urethra
TURP major complications
bleeding infection urinary incontinence ED retrograde ejaculatio urethral strictures failure to resolve symptoms
