BPH Flashcards
how to self treat BPH
Urinate as soon as you feel the urge
timed voiding schedules, even if no urge
over the counter decongestants or anti-histamine medications can make it harder for the bladder to empty
moderate alcohol and caffeine, especially in the hours after dinner
Reduce stress
Exercise regularly
α1-Adrenergic Receptor Antagonists
-azosin
-tamsulosin (prostate specific)
Decrease peripheral vascular resistance and lower arterial blood pressure
a1-receptor antagonists ADRs
Dizziness, lack of energy, nasal congestion, HA, drowsiness
“first-dose” effect – exaggerated response
May need to adjust first dose to one-third of normal dose and give at bedtime
Inhibition of and retrograde ejaculation
Prazosin can retain sodium and water
Give with diuretic
“floppy iris” syndrome with tamsulosin
5α-Reductase Inhibitors
- finasteride/dutasteride
- Decreases formation of dihydrotestosterone in the prostate
- takes 6-12 months for effects, can reduce PSAbest
5a-Reducatase inhibitors ADRs
Erectile dysfunction Ejaculatory dysfunction Decreased libido Depression, anxiety Rare – breast tenderness and enlargement “floppy iris” syndrome with finasteride
best way to treat BPH?
combo of both meds
when is sx recommended for BPH?
kidney failure bladder stones recurrent UTIs incontinence inability to empty the bladder recurrent blood in the urine
Loss of urine when a woman coughs, laughs, sneezes, lifts
Leaks also can happen when a woman walks, runs, or exercises
Weakening of the tissues that support the bladder or the muscles of the urethra
stress incontinence
Leakage of urine caused by “overactive bladder” muscles that contract too often or problems with the nerves that send signals to the bladder
Strong urge to urinate and an inability to get to the toilet in time
urge incontinence
Steady loss of small amounts of urine when the bladder does not empty all the way during voiding and the amount of urine produced exceeds the capacity of the bladder
Underactive bladder muscle or blockage of the urethra
overflow incontinence
Muscarinic receptor antagonists for urge incontinence
inhibit effects of PNS stimulation (acetylcholine)
smooth muscle relaxation
inhibit bladder contractions
oxybutynyn Tolterodine Fesoterodine Darifenacin Solifenacin Trospium
relaxes the detrusor smooth muscle during the storage phase of the urinary bladder fill-void cycle
increases bladder capacity, used for overactive bladder
Mirabegron (Myrbetriq)
beta-3 adrenergic agonist
tricyclic antidepressant that may be used to treat mixed incontinence
Imipramine (Tofranil)
most common and most popular surgery for stress incontinence
Sub urethral Sling Procedures
