BNP

Question 1

What is BPH?

Answer 1

benign hyperplasia of the prostate

Question 2

what are some voiding symptoms?

Answer 2

1. weak flow
2. straining
3. terminal dribbling
4. incomplete emptying
   (HITS)

Question 3

what are some storage symptoms?

Answer 3

1. frequency
2. urgency
3. nocturia

Question 4

What are some complications of BPH?

Answer 4

1. UTI
2. acute urinary retention
3. chronic renal failure (hydronephrosis) due to chronic renal failure

Question 5

first line mx

Answer 5

1. alpha antagonist - Tamusolin / Alfuzosin

- decreases smooth muscle tone

Question 6

adverse side effects of alpha antagonists?

Answer 6

1. dizziness
2. postural hypertension
3. dry mouth

Question 7

2nd line mx

Answer 7

5 alpha reductase inhibitors - Finasteride

• block conversion of testosterone to DHT which is known to induce BPH
• reduces prostate volume - slows down disease progression

Question 8

adverse side effects of 5 alpha reductase inhibitors?

Answer 8

1. erectile dysfunction, reduced libido and ejaculation problems

Question 9

what is the gold standard mx?

Answer 9

TURP

transurethral resection of the prostate tissue

Question 10

when is long term catheterisation indicated?

Answer 10

patients with prostatic obstruction unsuitable for TURP

Question 11

Ix and examinations

Answer 11

1. Examinations
   - DRE/abdo/genitals
2. Ix
   - PSA/USS/eGFR
   - Flow rate and residual volume
   - urinalysis / check for uti

Question 12

acute urinary retention

Answer 12

1. urological emergency - sudden inability to pass urine
2. severe lower abdominal pain
3. palpable bladder and dull to percuss

Question 13

Name 3 complication of TURP?

Answer 13

1. haemorrhaging
2. septicaemia
3. retrograde ejaculation
4. incontinence

Question 14

Mx of acute urinary retention?

Answer 14

1. urgent urinary catheterisation

2. tx the cause of urinary retention before catheter is removed