BPH ☺️

Question 1

Risk factors

Answer 1

Increased age

Most common in black, then white, then asian

Question 2

Presentation

Answer 2

LUTS
Voiding
-weak, intermittent flow
-straining
-terminal dribbling
-incomplete emptying

Storage

• urgency
• increased frequency
• incontinence
• nocturia

Question 3

Complications of untreated BPH

Answer 3

UTIs
Retention
Obstructive uropathyq

Question 4

Management

• conservative
• medical (1st, 2nd line and SE)
• surgical

Answer 4

Watchful waiting

1st line - a1 ant

• tamulosin => decrease SM tone in prostate, bladder
• SE - dizzy, postural hypotension, dry mouth, depression

2nd line - 5ARinh

• finasteride => block T -> DHT which causes BPH
• reduction in prostate volume but takes time
• SE - ED, low libido, ejaculation issues, gynecomastia

Surgery - TURP