BPH1 Flashcards
what are the top 5 conditions too embarrassing to talk about with PCP (in order)?
- impotence
- STDs
- Physical and sexual abuse
- prostate problems
- incontinence
what is the age relation to BPH
- uncommon under 50 (50% of men over 50)
- peaks at 63-65
- guaranteed if lig long enough
what is hyperplasia?
increased number of cells
what is hypertrophy?
increased size of cells
is BPH an example of hyperplasia, hypertrophy or both?
is it malignant?
hyperplasia, not hypertrophy
increase in cells, not size of cells
not malignant
define BPH
nonmalignant enlargement of prostate gland
BPH sometimes leads to what anatomical problem?
compression of the urethra and urine flow obstruction
what are the 3 normal prostate tissues
- epithelial - grandular tissue
- stromal - smooth muscle tissue
- capsule
what are the two types of pathophysiology involved with BPH? briefly describe each
- static - androgens cause hyperplasia
2. dynamic - andrenergic tone causes transient effect
what type of pathophysiology is involved in blocking bladdr neck and urinary flow?
static symptoms
what type of pathophysiology includes constriction of urethra and narrowing of lumen
dynamic symptoms
what sympathetic transmitters lead to dynamic symptoms of BPH?
epinephrine and norepinephrine
5-alpha reductase inhibitors deals with what pathophysiology of BPH?
androgens leading to static symptoms
adrenergic receptor blockers deal with what pathophysiology of BPH?
adrenergic tone leading to dynamic symptoms
cholenergics have what effect on bladder
contract bladder muscles
LUTS refers to what?
what are two causes of this?
how does it correlate to age?
lower urinary tract symptoms Causes: -bladder outlet obstruction -overactive bladder rates of these symptoms progress with age
hesitancy, intermittency, and terminal dribbling are what type of symptoms
static LUTS symptoms
frequency, urgency, dysuria and incontinence are symbpoms of what
dynamic LUTS symptoms
what is most common reason people don’t report BPH to doctor
compensation
what are the most common complications of untreated BPH?
Gross hematuria Overflow urinary incontinence/ unstable bladder Bladder diverticula Bladder stones Acute or chronic renal failure Recurrent UTI
what are the clinical signs of BPH?
- digital rectal exam (DRE) reveals enlarged prostate
2. greater than 20 gram prostate that is smooth, soft, symmetrical and mobile
what lab values indicate BPH?
- BUN
- SCr
- elevate prostate specific antigen
- urinalysis
- peak urinary flow rate
6 post void residual urine volume
what peak urinary flow rate indicates BPH
less than 10 ml per second
what post-void residual volume (PVR) level indicates bph
more than 25-50 ml
describe the American urological association symptom index?
a self administered, quantitative measure of extent of symptoms.
not a diagnostic tool
7 questions, then add up score
what are the 3 stages and ranges of AUASI?
- mild = 0-7
- moderate = 8-19
- severe = 20-35
what is considered clinically significant change in AUASI?
a change in score of 3 or more
what are 5 alpha blockers used for BPH?
- doxazosin
- Terazosin
- Tamsulosin
- Alfuzosin
- Silodosin
True/False
- Size of prostate is directly correlated with symptoms
- PSA is directly correlated with symptoms
- false
2. false
what are 4 goals of treatment of BPH
- improvement of voiding symptoms
- improve quality of life
- prevent disease infection
- prevent complication and treatment related effects
what does PSA stand for?
prostate specific antigen
