Benign Prostatic Hyperplasia Flashcards
what does it mean when something is a hyperplastic process?
increased # of cells
what are the obstructive sings of BPH?
hesitancy
decreased force or caliber of stream
sensing incomplete bladder emptying
double voiding
straining to urinate
dribbling
irritative sx of BPH (secondary response of the bladder to outlet resistance)
urgency
frequency
nocturia
what is an important tool to be used for evaluation of patients with BPH?
American Urological Association (AUA) sx index.
on DRE, what should alert you to the possibility of cancer?
induration
what are the components of the physical exam for BPH
DRE
Neuro
Abdominal Exam
What is the treatment for BPH?
watchful waiting (scores between 0-7 on AUA index)
Medical therapy for BPH:
alpha blockers (end in -sin)
5 alpha reductase inhibitors
phosphodiesterase 5 inhibitors
surgical therapy
what are the absolute surgical indications of BPH?
refractory urinary retention (failing at least one attempt at catheterization)
large bladder diverticula
sequelae of BPH (recurrent UTI, gross hematuria, stones, kidney disease)
what are the conventional BPH surgical therapies
Transurethral resection of the prostate (TURP)
Transurethral incision of the prostate (TUIP)
open simple prostatectomy
what are the minimally invasive surgical therapies for BPH
laser therapy
Transurethral needle ablation of the prostate (TUNA)
transurethral electro vaporization of the prostate
hyperthermia
implant, to open urethra
Criteria for referral to Urology for BPH?
AUA score greater than 7
urinary retention
hematuria
recurrent UTI
kidney disease
