Flashcards in BPH Deck (19)
What is BPH?
benign enlargement of prostate
there is physiological enlargment of prostate which occurs with age
what is the clinical relevance of an enlarged prostate?
- if it causes urinary symptoms of urinary outflow obstruction (UOO) or LUTS
non specific term for symptoms attributable to LUT dysfunction
what is BOO?
bladder outlet obstruction caused by BPE
what are the different zones in prostate anatomy?
- Anterior fibromuscular zone
- Transition zone
- Peripheral zone
- Central zone
which zones enlarge as people get older?
central and transitional zones
how does this enlargement cause symptoms?
as the urethra lies in the middle of these, enlargement can press on it = leads to LUTS and UOO
where does prostate cancer often develop?
often develops in fibromuscular zone so does not cause LUTs and UOO
what are the storage symptoms (irritative) of a LUTS?
- often due to wrong neurological signals to bladder
- leads to detrusor over activity
- determine whether its due to obstruction or inflammation
if its due to inflammation of the bladder, what is treatment?
what are the voiding symptoms (obstructive) symptoms of LUTS?
typically described as poor flow
- weak urinary symptoms
- incomplete emptying
- post void dribbling
what are the risk factors for BPH?
- androgen receptors
- diabetes and dyslipidaemia
what examinations should you do in the assessment?
- abdo examination
- DRE (enlargement of prostate 5-6cm worrying)
- urine dipstick
- flow rate assessment
- blood tests (UE, PSA)
what is the conservative management of BPH?
- reassure no cancer
- fluid intake advice
what is the medical management of BPH?
- alpha blockers (tamsulosin)
- 5 alpha reductase (finasteride)
what is the surgical management of BPH?
- TURP (transurethral resection of prostrate)
- alternative laser surgery
- alternative permanent catheterisation
what is chronic urinary retention?
postvoid residual over 800ml
what are the test results of low pressure chronic retention?
normal urine and creatinine