Benign Prostatic Hyperplasia Flashcards
What is benign prostatic hyperplasia?
A non-cancerous increase in the size of the prostate due to increase cell number that will present with both voiding and storage symptoms
Physical examination of BPH may show…?
A prostate volume of more than 30g, nodule or tenderness
What are the key storage symptoms of BPH?
Frequency
Urgency
Nocturia
Incontinence
What are the key voiding symptoms of BPH?
Weak stream Hesitancy Intermittency Straining Incomplete emptying Post-void dribbling
What are the possible complications of BPH?
UTI
Bladder stones
Chromic kidney problems
What are the risk factors of BPH?
Age over 50 Positive family history Non-asian race Smoking Obesity Diabetes type II Erectile dysfunctions Male pattern baldness Metabolic syndrome
What is the pathophysiology of BPH?
As men age, the enzyme 5-aloha reductase increases in activity, this converts testosterone to dihydrotestosterone. DHT promotes the growth and division of epithelial and stromal cells. This can cause hyperplasia
How would BPH by diagnostically investigated?
By physical rectal exam Increased PDA levels (not reliable) International prostate symptom score Volume charting Ultrasound CT Cytoscopy Uroflowtrometry
A behavioural management programme can be used to treat BPH. What does this involve?
Limitation of fluids
Bladder training focused in timed and complete voiding
Treatment of constipation
What medications would be considered for treatment of mild BPH?
Alpha blockers, phosphodiesterase-5 inhibitors, NSAIDs
At what stage would BPH patients be referred to surgery?
When the prostate is greater than 80g
TURP is the standard surgical treatment for BPH. What is it?
TURP is transurethral resection of the prostate,
Tissue is removed by electrocautery or sharp dissection
