Benign Conditions Prostate

Question 1

IPSS

Answer 1

International PRostate Symptom Score

0-7 Mild
8-19 Mod
20+ severe

Question 2

Alpha blocking mech for BPH

Answer 2

• alpha-1A receptors mediate bladder neck + prostate

- selective blockers allow relaxation of bladder neck + prostate w/ out affecting bladder contraction

Question 3

Non-FDA approved alpha-blockers for BPH

Answer 3

• Phenoxybenzamine (Nonselective)

- Prazosin (selective a1 antagonist)

Question 4

FDA-approved alpha blockers for BPH

Answer 4

Long-lasting a-blockers

• Terazosin
• Doxazosin
• Alfuzosin

Long-actign subtype for alpha-1A
- Tamsulosin

Question 5

BPH a-blockers

• Benefits
• Possible SE

Answer 5

• Rapid onset; long-term maintenance; Imprive lipid profile, insulin sens, + platelet aggr
• Postural Hypotension, Asthenia, Dizziness,m Somnolence, Nasal Congestion; *Intraoperative Floppy Iris Syndrome (cataract Sx)

Question 6

Silodosin

Answer 6

Silodosin(Rapaflo) a new alpha –blocker exhibiting higher selectivity for alpha 1a

Question 7

5aR Inhibitors

• Mech
• SE

Answer 7

• Mech: Lower serum + intraprostatic DHT

- SE: Impotence, DEC ejac volume, DEC Libido, Gynecomastia

Question 8

a-blocker + 5asRI Combo Therapy

Answer 8

• Finasteride alone or in combo w/ terazosin offered no benefit
• Risk reduction for BPH progression + AUR/invasive surgery

Question 9

PDE 5 for BPH

Answer 9

Tadalifil

Question 10

Chronic Abacterial Prostatitis

Answer 10

• Abx Tc 4 wks
• Anti-inflammatory agents
• alpha-blockers
• Prostatectomy NOT indicated

Question 11

Bacterial Prostatitis Tx

Answer 11

• Cabenicillin
• Fluoroquinolones (2nd gen)
• Doxy
• TMP (Not SMX)
• Rifampin (TB)
• Erythromycin