Diseases of Prostate Flashcards
How big is prostate
20cc
What are the Prostatic Zones called
McNeal
What is Benign Prostatic Hyperplasia characterised by
FIbromuscular and Glandular Hyperplasia
Benign Prostatic Hyperplasia affects
Transition Zone
Benign Prostatic Hyperplasia is disordered regulation of
Dihydrotestosterone
50% of men with BPH have moderate to severe
LUTS
Benign Prostatic Hyperplasia can result in
BPO or BOO
International Prostate Symptom Score Sheet Mild
0-7
International Prostate Symptom Score Sheet Moderate
8-19
International Prostate Symptom Score Sheet Severe
> 20
Tests for Benign Prostatic Hyperplasia
MSSU Flow Rate Study Post Void Bladder Residual USS Bloods: PSA Urea and Creatinine (chronic retention)
If renal failure suspected test
renal tract uss
if bladder stone suspected test
renal tract uss
if haematuria test
flexible cystoscopy
if psa raised test or abnormal DRE
TRUS guided prostate biopsy
what medication can be used for risk factors of prostate obstruction
5 alpha reductase inhibitor
alpha blocker
Treatment of uncomplicated BPO medical
5 alpha reductase inhibitor
alpha blockers
treatment of uncomplicated boo surgical
turn if prostate <100
open retropubic or transvesical prostatectomy if prostate >100
name 2 5 alpha reductase inhibitors that could be used for uncomplicated boo
finasteride or dutasteride
Alpha Blockers are
main treatment for LUTS due to BPO
Smooth muscle of bladder neck and prostate are innervated by
sympathetic alpha adrenergic nerves (Alpha 1)
What do alpha blockers do in prostate disease
cause smooth muscle relaxation and antagonist
Non Selective Alpha Blockers examples
phenoxybenzamine
Selective short acting alpha blockers examples
proposing, indoramin
selective long acting alpha blockers examples
alfuzosin, doxazosin
highly selective alpha blockers examples
tamsulosin
what do 5a reductase inhibitors do
convert testosterone to dihydrotestosterone
which 5a reductase inhibitors available for uncomplicated bpo
finasteride (type 2 inhibitor)
dutarsteride (type 1 and type 2 inhibitor)
role of 5a reductase inhibitors in prostate disease
reduce prostate size
reduce risk of progression of BPE if prostate >25cc
Reduces LUtS but alpha blockers better for this
potential role in prostate cancer prevention
Gold standard for BPO
TURP
Treatment of complicated BPO
No role for medical therapy except for acute urinary retention
Cystolitholapaxy and TURP for patients with BPO and bladder stones
Catherisation
The following are absolute indications for surgical intervention in patients with benign prostatic obstruction except:
a. refractory acute urinary retention
b. refractory chronic urinary retention
c. renal failure
d. recurrent UTI
e. bladder stones
b. refractory chronic urinary retention
The following are causes of acute urinary retention in men except:
a. spinal cord compression
b. urinary tract infection
c. constipation
d. pain from laparotomy wound
e. cystoscopy under local anaesthetic
e. cystoscopy under local anaesthetic
- Short-term urethral catheters (e.g. latex-based ones) should not be left in-situ for longer than:a. 1 week
b. 4 weeks
c. 8 weeks
d. 12 weeks
e. 16 weeks
b 4 weeks
Long-term urethral catheters (e.g. silicone-based ones) should not be left in-situ for longer than:
a. 1 week b. 4 weeks c. 8 weeks d. 12 weeks e. 16 weeks
12 weeks
