Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3: MED2 Y3 - Renal and Urinary [17] > [7] Benign Prostatic Hypertrophy > Flashcards

[7] Benign Prostatic Hypertrophy Flashcards

1
Q

What % of 60 year olds have BPH?

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What % of 80 year olds have BPH?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is BPH?

A

Benign nodular or diffuse hyperplasia of stromal and epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does BPH affect?

A

The inner (transitional) layer of the prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the result of BPH affecting the inner layer of the prostate?

A

Causes urethral compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is DHT produced?

A

It is produced from testosterone in stromal cells by 5alpha-reductase enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What effect does DHT have on the prostate?

A

It causes the production of DHT-induced growth factors, which increase stromal cells and decrease epithelial cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the categories of symptoms of BPH?

A

Storage symptoms
Voiding symptoms
Symptoms secondary to stasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the storage symptoms of BPH?

A

Nocturia
Frequency
Urgency
Overflow incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the voiding symptoms of BPH?

A 
Hesitancy
Straining
Poor stream/flow + terminal dribbling
Strangury 
Incomplete emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What symptom does strangury produce?

A

Urinary tenesmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the symptoms secondary to stasis in BPH?

A

Bladder stones

UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is found on PR examination in BPH?

A

Smoothly enlarged prostate

Definable median sulcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is the bladder palpable in BPH?

A

Not usually, unless acute-on-chronic obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations should be done in BPH?

A 
Blood
Urine
Imaging
Urodynamics
Voiding diary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What bloods should in done in BPH?

A

U&E

PSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What urine investigations should be done in BPH?

A

Dip

MC&S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What imaging should be done in BPH?

A

Transrectal US, with or without biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What urodynamic study should be done in BPH?

A

Pressure/flow cystometry

20
Q

What is involved in the conservative management of BPH?

A

Decrease intake of caffeine and alcohol
Double voiding
Bladder training

21
Q

What is involved in bladder training?

A

Hold on to urine to increase time between voiding

22
Q

When is medical management of BPH useful?

A

In mild disease, and while awaiting TURP

23
Q

What is the first line medical treatment of BPH?

A

Alpha-blockers

24
Q

Give two examples of alpha-blockers?

A

Tamsulosin

Doxazosin

25
How do alpha-blockers work in BPH?
They relax prostate smooth muscle
26
What are the side effects of alpha blockers?
Drowsiness Decreased BP Depression Extra-pyramidal side effects
27
What is the second line medical treatment of BPH?
5alpha-reductase inhibitors
28
Give an example of a 5-alpha-reductase inhibitor?
Finasteride
29
How do 5-alpha-reductase inhibitors work in BPH?
They inhibit the conversion of testosterone to DHT
30
When are 5-alpha-reductase inhibitors preferred in BPH?
Where there is a significantly enlarged prostate
31
What are the side effects of 5-alpha-reductase inhibitors?
``` Erectile dysfunction (Excreted in semen, so have to use condoms) ```
32
What are the indications for the surgical management of BPH?
Symptoms affecting QoL | Complications of BPH
33
What are the options for surgical management of BPH?
TURP Transurethral incision of prostate (TUIP) Transurethral electrovaporisation of prostate Laser prostatectomy Open retrograde prostatectomy
34
What happens in TURP?
Cystoscopic resection of lateral and middle lobes
35
What % of patients who have TURP become impotent?
<14%
36
What is the advantage of TUIP over TURP?
There is less destruction, and therefore a lower risk of sexual dysfunction
37
When does TUIP have similar benefits to TURP?
When small prostate (<30g)
38
What happens in transurethral electrovaporisation of prostate?
Electric current is used to cause tissue vaporisation
39
What is the advantage of laser prostatectomy over TURP?
It has a similar efficacy as TURP, but reduced risk of erectile dysfunction and retrograde ejaculation
40
What is open retropubic prostatectomy used for?
Very large prostates (>100g)
41
What are the immediate complications of TURP?
TUR syndrome | Haemorrhage
42
What happens in TUR syndrome?
Absorption of large quantities of fluids leads to reduced sodium
43
What are the early complications of TURP?
Haemorrhage Infection Clot retention
44
What does clot retention as a complication of TURP require?
Bladder irrigation
45
What are the late complications of TURP?
``` Retrograde ejaculation Erectile dysfunction Incontinence Urethral stricture Recurrence ```

3: MED2 Y3 - Renal and Urinary [17] (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions