BPH

Question 1

Pathology?

Answer 1

hyperplasia of stromal and epithelial cells of prostate (increase in size as opposed to number)

Question 2

dependant on what?

Answer 2

hormones

Question 3

Presentation? SSHEDSUFI

Answer 3

LUTS…

Straining

Stream poor

Hesitancy

Emptying incomplete

Dribbling

Strangury

Urgency

Frequency

Intermittency

Question 4

Ix?

Answer 4

1. Urine dipstick- exclude infection
2. PSA - always prior to DRE
3. DRE

Question 5

Mx?

Answer 5

• reassurance & monitoring
• Medical Mx
  
  • 1. Alpha blockers eg tamsulosin- relax smooth muscle
  • 2. 5-alpha-reductase inhibitors eg Finasteride
       * block peripheral conversion of testosterone & help shrink prostate
• Surgical Mx
  
  • TURP
  • TUVP
  • HoLEP
  • Open Prostatectomy

Question 6

disadvantage of 5 alpha reductase inhibitors?

Answer 6

take up to 6 months to work

Question 7

what does TURP involve?

Answer 7

accessing prostate through urethra and shaving off prostate tissue from inside using diathermy

Question 8

major complications of TURP?

Answer 8

• bleeding
• infection
• retrograde ejaculation
• urethral strictures
• incontinence
• erectile dysfunction
• post-TURP syndrome
  
  • causes electrolyte abnormalities

Question 9

how does TUVP work?

Answer 9

Transurethral electrovaporisation of the prostate

• prostate tissue removed using laser

Question 10

how does HoLEP work?

Answer 10

prostate tissue removed using an electrical current