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
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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
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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

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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
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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
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