Benign Prostatic Hyperplasia Flashcards
def
enlargement of the prostate which causes bladder outlet obstruction
what are the two components of benign prostatic hyperplasia
static component (enlargement of prostate which narrows urethra) dynamic component (increased prostatic SM)
epi
increases with age
aetiology
it has been suggested that age related hormonal changes result in androgen:oestrogen imbalances
this results in hyperplasia of the prosate
what is pathological BPH
symptomatic BPH and may require prostatis
risk factors
elderly males
history
urinary symptoms such as increased frequency, but associated with hesistancy, decreased volume of urine with a weak stream and incomplete emptying
patient may complain of nocturia
examination
may be an enlarged prostate on PR
signs of urinary retention
investigations
1 increased PSA may indicate prostate cancer or prostatis
2 urinalysis
-pyuria (pus in the urine from bacteria infection if UTI is implicated)
management
if asymptomatic - monitor
if symptomatic use of an alpha blocker such as terazosin or doxazosin (cause SM relaxation in prostate), or phosphodiesterase-5 inhibitor or NSAIDs
if abnormal PR exam +/ elevated PSA surgical referral is required to remove prostate
complications
BPH progression
urinary retention
prognosis
medical treatment usually improves symptoms
a 60y/o man presents with a 3/12 history of increasing urinary frequency without burning, and nocturia. He has limited fluid consumption and caffeine intake without benefit. No personal of family history of prostate cancer. PR exam demonstrates a moderately enlarged prostate without nodules or tenderness
BPH
