BPH Flashcards
1
Q
Normal Prostate Physiology
A
- Anterior to rectum
- Below Bladder
- Surrounds the proximal urethra
- Round, soft, symmetric, mobile
- 4 to 20g in weight
2
Q
Stromal tissue (smooth muscle tissue)
A
- Alpha one adrenergic receptors
- Norepinephrine can cause these muscles to contract
- Reducing urethral lumen
- Decreasing bladder emptying
3
Q
Epithelial Tieesue
A
- Produces prostatic secretions
- Works under androgen control
4
Q
Androgens are converted by _____ in target cells to ______
A
- 5 alpha reductase
- DHT
5
Q
Type 1 enzymes
A
Hair, skin, liver, etc.
6
Q
Type 2 enzymes
A
localized in prostate, genital tissues, and scalp
7
Q
Increasing DHT does what to prostate size
A
-Increases the size of the prostate
8
Q
Static Factors
A
- Enlargement of prostate gland
- Physical block at bladder neck
- Androgen stimulation of epithelial tissues
- Estrogen stimulation of stromal tissue
9
Q
Dynamic factos
A
- Excessive alpha adrenergic tone
- Prostate gland
- Bladder neck
- Posterer urethra
- Contraction of prostatic gland around urethra
10
Q
How does testosterone replacement effect BPH
A
- Testosterone is metabolized into DHT
- Increasing the size of the prostate
11
Q
How do alpha one adrenergic agonists effect BPH
A
- They increase smooth muscle contraction
- Leading to decreased urethral lumen
12
Q
How do anticholinergic drugs effect BPH
A
- Decrease urinary bladder detrusor muscle contractility
- Making it harder to completely empty the bladder
- Increasing urinary retention
13
Q
Clinical presentation of BPH
A
- No acute distress
- Urinary symptoms
- Prostate greater than 20g
- BUN, SCr, elevated PSA
- Increased AUA score
- Decreased urinary flow < 10mL/s
- Post void residual (PVR) volume
14
Q
Obstructive symptoms
A
- Prostate/bladder obstruction
- Decreased bladder emptying
15
Q
Irritative symptoms
A
- Late in disease course
- From long standing obstruction
- Bladder hypertrophies
- Decompensation occurs
