BPH

Question 1

What is Benign Prostate Hyperplasia?

Answer 1

BPH describes the natural enlargement of the prostate leading to LUTS sx:

Urinary frequency, incomplete emptying, dribbling, hesitancy, and nocturia

Question 2

What causes BPH?

Answer 2

INCREASING AGE

BPH is associated with increasing age. Hormone dependant process where testosterone involvement, apoptosis failure and proliferation

This proliferation occurs primarily in the transitional zone of the prostate, this leads to restriction of the prostatic urethra and urinary flow.

Question 3

How does BPH present?

Answer 3

Most commonly: Increased urinary frequency, Nocturia and incomplete emptying

LUTS sx

Storage - FUNI
* Frequency,
* Urgency,
* Incontinence,
* Nocturia

Voiding SHID
* poor Stream- decreased urinary flow
* Hesitancy
* Incomplete emptying
* Dribbling

Question 4

How is BPH classified?

Answer 4

IPS The International Prostate Symptom Score is a questionnaire that categorises the impact of prostate symptoms

Question 5

How is BPH Diagnosed?

Answer 5

GS- Digital rectal examination
SMOOTH Enlarged Prostate

DDx Prostate cancer : Hard and irregular growth

PSA - Prostate specific antigen
Can be raised w/ejaculation, infection and exercise

ALL LUTS SHOULD DO
Other urinalysis - Urine dipstick , Midstream MC+S

Question 5

How is BPH managed?

Answer 5

Tx aims at reducing symptoms and preventing complications (LUTS, Infection)

Conservative - Long term catheter, reduce caffeine

Medical
Tamsulosin - Alpha 1 blocker
(Inhibits SNS Sphincter contraction)

Finasteride - 5Alpha -reductase
Inhibits test production = reduced size

Surgical - TURP
Transurethral Resection of the Prostate (TURP)
Resect obstructing tissue

Question 6

BPH complication

Answer 6

Anuria - No urine production
Obstructive uropathy