Benign Prostatic Hyperplasia

Question 1

What is benign prostatic hyperplasia?

Answer 1

benign enlargement of the prostate leading to external compression and obstruction of the prostatic urethra

Question 2

What are the three parts of the prostate?

Answer 2

• transition zone 10% (where BPH happens)
• central zone 20%
• peripheral zone 70%

Question 3

What is the pathophysiology of benign prostatic hyperplasia?

Answer 3

• prostate has 5-alpha reductase which converts testosterone into DHT
• DHT acts a growth factor
• also alpha-1-adrenoceptors in SMC which can be activated and worsen lower urinary tract symptoms
• combination of overgrowth and increased smooth muscle

Question 4

What are some symptoms of benign prostatic hyperplasia?

Answer 4

• Obstructive symptoms: trouble initiating, spraying, dribbling, incomplete emptying, straining, nocturia
• May have irritative symptoms as a result of obstructive symptoms:
• frequency
• urgency
• dysuria
• haematuria

Question 5

What examinations are done for benign prostatic hyperplasia?

Answer 5

• PR exam
• assess supra-pubic region for signs of distention/retention
• neuro to look for nerve deficit

Question 6

What is the management of benign prostatic hyperplasia?

Answer 6

• mild is reassurance and reduction of caffeine
• mod is alpha 1 blockers and 5-alpha reductase inhibitors
• severe is TURP