Prostatic Hyperplasia

Question 1

Define

Answer 1

Increase in the size of the prostatic gland without malignancy

Question 2

Pathophysiology

Answer 2

Glandular epithelial cells and stroll cells undergo hyperplasia
Usually the MEDIAN LOBE is affected

Question 3

Aetiology

Answer 3

Not fully known.

Assumed relationship to androgens, possibly promoting cell proliferation in the prostate.

Question 4

Epidemiology

Answer 4

Affects QOL of:
40% of men in 50s
90% of men in 90s

Question 5

Clinical presentation

Answer 5

Frequent urination
Incomplete emptying
Intermittent stream
Weak stream
Urgency
Nocturia
Straining (I-PSS grading)

Question 6

Diagnosis

Answer 6

History
Ultrasound
DRE

Question 7

Treatment

Answer 7

Watchful waiting.
Alpha blockers (doxazosin) to those with severe voiding problems.
5-alpha reductase inhibitor (finasteride)
Surgery: Large prostate/failure to respond; transurethral resection of the prostate.

Question 8

Complications

Answer 8

Recurrent UTI. Bladder calculi.

Question 9

Treatment - example of alpha blocker

Answer 9

Doxazosin or Tamsulosin

Question 10

Treatment - example of 5-alpha reductase inhibitor

Answer 10

Finasteride