BPH

Question 1

What is BPH

Answer 1

Proliferation of both stromal and epithelial elements

Question 2

Clinical presentation

Answer 2

Hesitancy, poor stream, post-micturition dribble, frequency, urgency, incontinence, nocturnia

Sometimes dysuria and haematuria

Question 3

What can Lower urinary tract symptoms lead to

Answer 3

Acute or chronic retention

Question 4

How can chronic retention present as

Answer 4

Bladder stones
Chronic renal failure
Incontinence
Urinary tract infections

Question 5

How to assess Lower urinary tract infections

Answer 5

History and examination 
DRE
Quantification of symptoms severity 
Flow rate 
Urinary dipstick
Blood tests

Question 6

Management of BPH for mild symptoms

Answer 6

Reassure
Lifestyle modification
Follow-up

Question 7

Management for moderate symptoms

Answer 7

Pharmacotherapy
Alpha-blockers (adrenoceptor antagonists)
5-alpha reductase inhibitors
Anticholinergics

Question 8

Management for severe symptoms

Answer 8

Surgery

Question 9

Role of alpha blockers

Side effects

Answer 9

Adrenoceptor antagonists
-Relaxes SM

Side effects: postural hypotension and dizziness
-Retrograde ejaculate

Question 10

Action of 5- alpha reductase inhibitors

Answer 10

Blocks formation of dihydrotestosterone from testosterone. This means less dihydrotestosterone reaches androgen receptor in prostate and it shrinks

Question 11

Surgery for BPH

Answer 11

TURP (go into urethra and shave away prostate)

-Complications: bleeding, UTI, incontinence and impotence