Benign Prostatic hyperplasia

Question 1

what is bph?

Answer 1

Non malignant hyperplasia of prostate, normal with ageing

Question 2

RF?

Answer 2

increased age, + ethnicity; afrocarribean = increased testosterone
Castration is protective

Question 3

Pathology?

Answer 3

Innertransitional zone of prostate (muscular gland) proliferate + narrows urethra

Question 4

Sx?

Answer 4

LUTs (lower urinary tract Sx) moreso VOIDING Sx
Anuria if totally occluded urethra - retention; hydronephrosis, UTI, stores

Question 5

Storage Sx and voiding Sx?

Answer 5

storage = frequency, urgency, nocturia (>30%), incontinence
Voiding = poor stream, dribbling, incomplete emptying, straining, dysuria

Question 6

Dx?

Answer 6

DRE (Digital rectal exam) - smooth enlarged (prostate cancer = hard irregular)

PSA (Prostate specific antigen) - rule out prostate cancer, very unreliable as can be raised in both, more in cancer

Question 7

Tx?
lifestyle?
drugs?
Surgery?

Answer 7

Low caffeine, may need catheter acutely

1st line = alpha blocker (tamsulosin) - relaxes bladder neck
2nd = 5 alpha reductase inhibitors (finasteride) - reduce testosterone and reduce prostate size

Surgery last resort (TURP - Transurethral resection of prostate)

Question 8

mc complication of TURP?

Answer 8

Retrograde ejaculation - semen enters bladder