Benign Prostatic Hyperplasia (BPH) & Urinary Retention

Question 1

Benign Prostatic Hyperplasia

Answer 1

Nonmalignant prostate enlargement by abnormal overgrowth of the prostate tissue

Question 2

What is Benign Prostatic Hyperplasia caused by?

Answer 2

Caused by excessive growth of epithelial (glandular) cells and smooth muscle cells

Question 3

How common is BPH?

Answer 3

BPH is a common disorder that affects 50% of men older than 60 years and 90% of men older than 70
years.

Question 4

As the prostate tissue grows in size, what happens?

Answer 4

As the tissue increases in size, it compresses the urethra and produces symptoms of bladder outlet
syndrome.

Question 5

What is the correlation between prostate size and symptoms?

Answer 5

No direct correlation between symptoms and size

Question 6

What kind of imbalance exists with Benign Prostatic Hyperplasia (BPH)

Answer 6

Testosterone/Estrogen imbalance

Question 7

Signs and symptoms of BPH

Answer 7

Urinary hesitancy
* Urinary urgency
* Increased frequency of urination
* Dysuria
* Nocturia
* Straining to void
* Postvoid dribbling
* Decreased force and caliber of urinary stream
* Sensation of incomplete bladder emptying

Question 8

What is used to evaluate for BPH?

Answer 8

1. Digital rectal examination (DRE)
2. Measurement of PSA levels
3. Transrectal ultrasound (TRUS)

Question 9

What does transrectal ultrasound do for BPH evaluation?

Answer 9

is used to determine bladder and prostate volume and residual urine.

Question 10

What medications are used to treat BPH?

Answer 10

5-Alpha-reductase inhibitors (mechanical obstruction)
* Finasteride

Alpha1-adrenergic antagonists (dynamic obstruction)

Question 11

Examples of alpha adrenergic blockers

Answer 11

Prozosin and tamsulosin

Question 12

What do alpha adrenergic blockers do?

Answer 12

are used to relax the smooth muscle of the bladder and prostate.

Question 13

What are treatment options for BPH?

Answer 13

• Surgery/Invasive procedures – TURP, laser prostatectomy, microwave tx
• Watchful waiting
• Drug therapy
• 5-Alpha-reductase inhibitors (mechanical obstruction)
• Finasteride
• Alpha1-adrenergic antagonists (dynamic obstruction)

Question 14

Two types of obstruction in BPH?

Answer 14

Dynamic Obstruction

Static Obstruction

Question 15

Dynamic Obstruction

Answer 15

Obstruction due to smooth muscle tone

Question 16

Static Obstruction

Answer 16

Obstruction due to enlargement of the prostate