Benign Prostatic Hypertrophy Flashcards
1
Q
How does it present?
A
It usually presents with lower urinary tract symptoms in older men. •Hesitancy •Urgency •Frequency •Intermittency •Straining to void •Terminal dribbling •Incomplete emptying
2
Q
Assessing BPH
A
- Urine dipstick (exclude injection as a major differential)
- PSA done prior to rectal examination can help with assessing potential for prostate cancer
- Rectal exam to assess prostate size, shape and characteristics
3
Q
Managing BPH
A
- Reassurance and monitoring if manageable symptoms
- Medications
◦Alpha blockers (relax smooth muscle; e.g. tamsulosin 400 mcg once daily)
◦5-alpha reductase inhibitors (block testosterone and actually help reduce the size of the prostate; e.g. finasteride)
•Surgery
◦Transurethral resection of the prostate (TURP)
◦Transurethral electrovaporisation of the prostate (TUVP)
◦Holmium laser enucleation of the prostate (HoLEP)
◦Open prostatectomy via abdominal or perineal incision
4
Q
What is Transurethral Resection of the Prostate (TURP)?
A
- Involves accessing the prostate through the urethra and “shaving” off prostate tissue from inside using diathermy
- Aim is to create a wider space for urine to flow through, thereby improving symptoms
5
Q
What are complications of TURP?
A
◦Bleeding ◦Infection ◦Incontinence ◦Retrograde ejaculation (semen goes backwards and is not produced from the urethra during ejaculation) ◦Urethral strictures ◦Failure to resolve symptoms ◦Erectile dysfunction