Benign Prostatic Hyperplasia

Question 1

what is BPH

Answer 1

hyperplasia of stromal and epithelial cells of the prostate

causing enlargement of the prostate

normally presents with lower urinary tract symptoms

common in over 50s men

Question 2

who gets BPH

Answer 2

old men
FH
diabetes
Obesity

Question 3

how does BPH present

Answer 3

Lower Urinary Tract Symptoms:

• Hesitancy
• Weak flow
• Terminal dribbling
• Straining
• Urgency and frequency
• Nocturia

Question 4

what signs would you expect to see in BPH OE

Answer 4

PR Exam:

• enlarged
• smooth
• non-tender

Lower abdo tenderness

palpable bladder- indicates urinary retentio

Question 5

how do you investigate BPH

Answer 5

• urinalysis-> pyuria
• PSA may be raised
• U and Es may show evidence of renal failure
• PR exam
• abdo exam

transrectal USS

Question 6

how do you manage BPH

Answer 6

Alpha 1 blockers (relaxes smooth muscles in the bladder) e.g. tamsulosin

5 alpha reductase inhibitors e.g. finasteride (5 a reductase helps testosterone which increases prostate size)

surgical resection of the prostate through the urethra

Question 7

what is the role of testosterone in the prostate

Answer 7

increases prostate size

helped by 5 alpha reductase

so 5 alpha reductase inhibitors e.g. finasteride arte given in BPH