BPH

Question 1

What scoring system can be used to assess severity of LUTS

Answer 1

International prostate system score

Question 2

What examinations/investigations would you do initially?

Answer 2

DRE
abdo exam
urinary frequency volume chart
urine dipstick
PSA

Question 3

what are causes of raised PSA

Answer 3

Prostate cancer
BPH
Prostatitis
UTI
Vigorous exercise - notably cycling
Recent ejaculation or prostate stimulation

Question 4

What is medical management of BPH?

Answer 4

Alpha blockers - tamsulosin - relax smooth muscle, rapid improvement in sx
5 alpha reductase inhibitors - finasteride - gradually reduce size of the prostate

Question 5

How do 5 alpha reductase inhibitors work?

Answer 5

Reduce dihydrotestosterone in tissues leading to reduction in prostate size

Question 6

How long do 5 alpha reductase inhibitors take to work?

Answer 6

6 months

Question 7

What are surgical options for treatment?

Answer 7

Transurethral resection of the prostate TURP
Open prostatectomy

Question 8

What are side effects of tamsulosin

Answer 8

postural hypotension

Question 9

What are side effects of finasteride

Answer 9

Sexual dysfunction due to reduced testosterone

Question 10

What are complications of TURP

Answer 10

Bleeding
infection
urinary incontinence
erectile dysfunction
retrograde ejaculation
urethral strictures
failure to resolve sx