BPH Flashcards
What are the Symptoms of BPH
WISE FUN
Weak stream
Intermittent Flow
Straining to urinate
inc Emptying
Frequency
Urgency
Nocturia
What is the Zonal anatomy of the Prostate?
Transition zone- BPH**
Central
Peripheral- 70% of Cancers*
Anterior Fibromuscular Stroma
What is the Pathophysiology of BPH?
Free Testosterone => DHT
DHT => Prostate Diff + Growth
How is BPH Diagnosed?
PVR (post void residual)
Prost Size, measurement of flow rate
What are the medical Tx of BPH?
Alpha Blockers- Helps symptoms
5a-reductase blockers -Shrinks prostate
Combo therapy- Finasteride and Doxazosin
What are the surgical Tx of BPH?
Trans Urethral Surgery
Open Prostatectomy
What are the Indications for medical Tx of BPH?
Not surgical candidates
What are the Indications for surgical Tx of BPH?
Acute urinary retention recurrent UTI Refractory Gross hematuria/Clot retention Bladder Stones Azotemia
What is in the Cantral Zone?
Surrounds Ejaculatory Duct
What is assessed in Digital Rectal exam?
Estimate size of prostate?
Assess for prostate nodule suspicious for cancer or rectal mass
Anal sphincter tone
What are the complication of BPH?
Acute Retention Renal Insufficiency Recurrent UTI Hematuria Bladder Calculi
What are the Alpha blockers that are used in BPH?
Terazosin Doxazosin Alfuzosin(uroselective) Tamsulosin* Silodosin*
What are the SE of Alpha blockers?
Ortho Hypotension Inc risk of falls Dizziness Floppy iris Ejac problems
