Benign Prostate Hyperplasia

Question 1

BPH is hyperplasia of what kind of tissue

Answer 1

glandular tissue

Question 2

and hypertrophy of what

Answer 2

smooth muscle and glands

Question 3

What is BPH

Answer 3

gradual periurethral enlargement around the urethra

Question 4

what is the most prevalent risk factor

Answer 4

age

Question 5

why is age the most prevalent risk factor

Answer 5

there is a change in the T:E ratio

Question 6

what kind of change is occurring in the T:E ratio

Answer 6

there is a quantitive decrease in T and a relative increase with E

Question 7

what are other Etiology of BPH

Answer 7

unclear, with a tie to diet, ethnicity, and genetic predisposition

Question 8

the patho of BPH is related to what

Answer 8

to changed in testosterone, dihydrotestosterone, and estrogen

Question 9

What converts T to DHT

Answer 9

5a reductase

Question 10

what does E do

Answer 10

sensitizes the prostate to DHT

Question 11

what does DHT do

Answer 11

promotes prostate growth and function

Question 12

hyperplasia of the periurethral tissue causes what

Answer 12

compression against the urethra

Question 13

hypertrophy of the smooth muscle cells causes what

Answer 13

impeded urine flow, and increase urine in the bladder

Question 14

What are the histologic changes that are occurring

Answer 14

the bladder wall thickens and trebeculations and diverticula are forming to create more room for the urine

Question 15

what is a complication that arises from this compensatory changes

Answer 15

urine stasis occurs = renal calculi and infections

Question 16

Consequences of BPH

Answer 16

Urine reflux

• urine is backed up in the ureters, ureters distend (hydroureter)
• ureter then fish hooks and loops down
• backs up into the kidney (hydronephrosis) which is distention of the renal pelvis and calices

Question 17

Manifestations of BPH

Answer 17

frequency
hesitancy 
poste urine dribble
week urine stream 
complete obstruction = renal failure

Question 18

Diagnosis of BPH- what is the golden standard

Answer 18

DRE

Prostate specific antigen (increases with the size)

Question 19

what are other diagnosis of BPH

Answer 19

PSAv, PSAd
US
BUN
Creatinine
Urinalysis

Question 20

Treatment for BPH

Answer 20

often no treatment
alpha adrenergic antagonists (relax smooth muscle)
5a reductase inhibitors

Question 21

Severe treatment

Answer 21

TURP (transurethral resection of the prostate)

laser prostatectomy