Prostate conditions Flashcards
What is BPH?
Benign prostatic hyperplasia
What is the pathology of BPH?
Caused by hyperplasia of the stromal and epithelial cells of the prostate
What does BPH present with?
LUTS
What are some examples of LUTS?
Hesitancy
Weak flow
urgency
Frequency
Intermittency
Straining
Terminal dribbling
Incomplete emptying
Nocturia
What is the initial assessment of men presenting with LUTS?
DRE- assess size, shape and characteristics of prostate
Abdominal exam- assess for palpable bladder
Urinary frequency volume chart
Urine dipstick
Prostate specific antigen (PSA)
What causes raised PSA?
Prostate cancer
BPH
Prostatitis
UTI
Vigorous exercise
Recent ejaculation or prostate stimulation
What are the features of a benign prostate?
Smooth
Symmetrical
Slightly soft
Maintained central sulcus
What are the features of a cancerous prostate?
Firm/hard
Asymmetrical
Craggy
Irregular
Loss of central sulcus
What is the medical treatment of BPH?
Alpha blockers (tamsulosin)- relax smooth muscle
5- alpha reductase inhibitors (finasteride)- reduce prostate size
How do 5-alpha reductase inhibitors work?
Converts testosterone to dihydrotestosterone (DHT)
What is the surgical treatment of BPH?
Transurethral resection of prostate (TURP)
Transurethral electrovaporisation of the prostate (TEVAP)
Open prostatectomy
What are complications of surgery?
Bleeding
Infection
Incontinence
Erectile dysfunction
Retrograde ejaculation
Urethral strictures
Failure to resolve symptoms
