Prostate Disease

Question 1

What advice should you offer patients with mild symptoms (after cancer excluded)?

Answer 1

Avoid certain drugs especially OTC cough and cold preparations
Avoid or reduce caffeine and alcohol
Avoid fluids before bedtime
Urinate when you need to (do not hold on)
Wait 30 seconds after voiding then try to void again

Question 2

What medical treatment is available for patients with BPH?

Answer 2

Alpha adrenergic blocking drugs eg prazosin to inhibit contraction of the muscle in the bladder neck and urethra
5 alpha reductase eg finasteride reduce prostatic volume

Question 3

What are absolute indications for a prostatectomy?

Answer 3

Deterioration in renal function
Development of upper tract dilatation
Retention (following drainage and assessment)
Bladder stones

Question 4

What drugs can cause lower urinary tract symptoms (LUTS)?

Answer 4

Atropine and hyoscine compounds
Antidepressants 
Antiparkinson agents
Ephenedrine
Salbutamol

Question 5

What are signs of an abnormal prostate on DRE?

Answer 5

Hard lump
Asymmetry
Induration
Loss of median sulcus

Question 6

What are clinical features of an enlarged prostate?

Answer 6

Hesitancy, frequency, urgency, nocturia, slow interrupted flow, terminal dribbling, acute retention, retention with overflow incontinence, haematuria from ruptured submucosal prostatic veins can occur, rectal examination usually detects and enlarged prostate