BPH

Question 1

S&S BPH

Answer 1

enlarged prostate, rubbery, lost median sulcus or forrow, decreased force of stream. increased freq of urination, nocturia, sensation of incomplete emptying.

Question 2

diagnostics for BPH

Answer 2

rule out infection w/UA
postvoid residual volume test
transrectal US
prostate biopsy

Question 3

Risk of BPH

Answer 3

prolonged –> hydronephorosis, renal function compromised , postrenal azotemia

Question 4

What is post renal azotemia

Answer 4

life threatening and includes elevated CR and BUN, urinary retention, and outflow obstruction

Question 5

tx bph?

Answer 5

avoid triggering drugs: TCA, first generation anithistamines (benadryl or chorphen)

foods: caffeine, etoh, artificial sweeteners

meds:
tamsulosin (flomax) - increases outflow, alpha receptor antagonists (dont use as first line or solo w/hypertension)

finasteride (proascar) and dutasteride (avodert) - 5 alpha reductase inhibitors

tadalafil - phosphodiesterase inhibitor (cant be use with alpha antagonist or nitrates

surgery - if less severe modalities do not assist

nutritional therapies - saw palmetto, rye, pukpin.