BPH Flashcards
1
Q
BPH
A
- common, benign nodular/diffuse proliferation of musculofibrous AND glandular layers of prostate
- the inner transitional zone enlarges
2
Q
features of BPH
A
LUTS
- nocturia
- frequency
- urgency
- post-micturition dribbling
- poor stream/flow
- overflow incontinence
- haematuria
- bladder stones
- UTI
3
Q
latent BPH
A
- Latent foci are increasingly seen with advancing age
- Are not clinically relevant but are histologically identical to overt cancers in other patients
4
Q
aetiology
A
- hormonal imbalance - alteration of androgen/oestrogen ratio
5
Q
investigations of BPH
A
- assess severity of symptoms and impact on life
- DRE
- MSU
- US
- rule out cancer: PSA, transrectal USS, biopsy
6
Q
how does BPH appear on DRE
A
smooth and rubbery, enlarged
7
Q
what does a raised PSA mean
A
not a reliable test - often raised by BPH
8
Q
histology
A
proliferation of glands AND stroma - looks like trees
9
Q
management
A
- lifestyle
- drugs
- surgery
10
Q
lifestyle management of BPH
A
- avoid caffeine and alcohol
- learn to control urgency eg by breathing methods
- train bladder to increase holding time on voiding
11
Q
drugs used in BPH
A
- a blocker eg tamsulosin, doxazosin
- symptomatic relief
- these relax the sphincter by decreasing muscle tone and allow for better urine flow
- finasteride
- reduces androgen activity, reducing prostate volume
12
Q
finasteride mechanism of action
A
decrease testosterone converstion to DHT
13
Q
warning with finasteride
A
- excreted in the semen, so condoms must be worn
- females should avoid handling
14
Q
surgery avilable for BPH
A
TURP of HolEP (laser)
15
Q
what is there a risk of with TURP
A
impotency - ≤14%
