Benign Prostatic Hypertrophy

Question 1

What is benign prostatic hypertrophy?

Answer 1

Hyperplastic process, meaning there is an increased number of cells.

Question 2

Is this the most common benign tumor in men?

Answer 2

Yes and it’s age related.

25% at 55 report obstructive voiding symptoms

50% at 75 report decrease in the force and caliber of the urinary stream.

Question 3

What are signs of benign prostatic hypertrophy?

Answer 3

Related either to the obstructive component of the prostate or to the secondary response of the bladder to the outlet resistance.

Question 4

What is the most important tool used in the evaluation of patients with BPH?

Answer 4

American urological association symptom index.
Answers to seven questions on a scale of 0-5

Question 5

What will you feel in digital rectal exam?

Answer 5

Smooth firm elastic enlargement of the prostate

Question 6

How do you treat BPH?

Answer 6

Watchful waiting, scored 0-7 should be managed by watchful waiting only.

Medical therapy
Alpha blockers (terasozin,tamsulosin)
5alphareductase inhibitors(finasteride)
Phosphodiasterase5 inhibitors(tadalafil)

Question 7

What are the absolute surgical indications?

Answer 7

Refractory urinary retention
Large bladder diverticula
Sequelae of benign prostatic hyperplasia

Conventional
TURP
TUIP
Open simple prostatectomy

Minimally invasive
Laser therapy
TUNA
Hyperthermia
Transurethral electrovaporization of the prostate
Implant, to open prostatic urethra