Benign Prostatic Hyperplasia

Question 1

What LUTS symptoms might someone with BPH present with?

Answer 1

Nocturia, frequency, urgency, post-micturition dribbling, poor stream/flow, hesitancy, incomplete emptying

Question 2

What investigations would you do?

Answer 2

DRE, PSA

Question 3

What lifestyle advice would you give?

Answer 3

Avoid caffeine and alcohol, relax when voiding, void twice in a row to aid emptying

Question 4

What drugs are 1st line and what do they do?

Answer 4

Alpha blockers and they decrease smooth muscle tone

Question 5

What drug is also available and what do they do?

Answer 5

5-alpha-reductase inhibitors and they decrease the conversion of testosterone to dihydrotestosterone

Question 6

What surgical procedures are available?

Answer 6

TURP, TUIP

Question 7

What are the benefits of TUIP over TURP?

Answer 7

It involves less destruction and less risk to sexual function

Question 8

What are the most common complications of TURP?

Answer 8

Retrograde ejaculation, ED, Incontinence, Haematuria, Impotency

Question 9

What is BPH?

Answer 9

Hyperplasia of the inner transitional zone of the prostate gland which partially blocks the urethra

Question 10

What would you feel on a DRE?

Answer 10

Smooth but enlarged prostate

Question 11

Give an example of an alpha blocker

Answer 11

Tamsulosin

Question 12

Give an example of a 5-alpha reductase inhibitor

Answer 12

Finasteride

Question 13

What are side effects of tamsulosin?

Answer 13

Postural hypotension, dizziness, syncope