BPH

Question 1

Presentation?

filling symptoms?
voiding symptoms?

Answer 1

Filling – Frequency, urgency, nocturia

Voiding – Poor stream, hesitancy and terminal dribbling

Question 2

Risk factors

Answer 2

o age: around 50% of 50-year-old men will have evidence of BPH and 30% will have symptoms.
o Around 80% of 80-year-old men have evidence of BPH
o ethnicity: black > white > Asian
o Testosterone

Question 3

Ix?

Answer 3

Urine dip
MC&S
Bloods
DRE

Question 4

Tx?

conservative?

medical?

surgical?

Answer 4

Conservative – Avoid caffeine + alcohol, void x2, bladder training

Medical
1st line = α blockers (tamsulosin)
2nd line = 5-α reductase inhibitor (finasteride) - LUTS + >30g prostates or PSA >1.4ng/ml

combine the two if severe

surgery
TURP – Transurethral resection of the prostate – Higher impotence risk than TUIP

TUIP – Transurethral incision of the prostate