Benign Prostatic Hypertrophy Flashcards
1
Q
BPH
A
benign enlargement of the prostate which impacts flow of urine through the prostatic urethra
usually age related
2
Q
Presentation
A
difficulty voiding:
poor stream, hesitancy, incomplete voiding, intermittency
storage:
nocturia, freq, dribbling, overflow incontinencem haematuria, bladder stones, UTI
3
Q
Investigations
A
Blood: PSA, Cr, UEC MSU international prostate symptom score IPSS Imaging: Abdo USS, Trans rectal USS Flow studies Biopsy: TR or TP
4
Q
Management
A
Education
Lifestyle:
- avoiding caffeine/alcohol
- physio to work on relaxation, distraction to decrease frequency, bladder diary + retaining
Medication: (IPSS 8-10) a-blockers (doxazosin, tamsulosin) - Smooth muscle relaxation - SE: drowsy, postural drop, dry mouth, ED 5 a reductase (finasteride) - blocks conversion of T to DHT - takes 6 months to work
Surgery TURP or HOLEP - bleeding - clot retention - retrograde ejaculation - secondary incontinence