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Benign Prostatic Hyperplasia (Symptoms (Urgency, Poor micturition,…
Benign Prostatic Hyperplasia
Epidemiology
Affects 24% of 40-64 year olds
Affects 40% of >65 year olds
Pathophysiology
Inner transitional zone
enlarges. In prostate cancer, the peripheral layer expands
Benign nodular or diffuse proliferation of musculofibrous and glandular layers of the prostate
Symptoms
Urgency
Poor micturition
Frequency
Poor stream
Nocturia
Overflow incontience
Hesitancy
Bladder stones
Haematuria
UTI
Investigations
MSU = mid stream urine
Urine dipstick
U&E
Transectal ultrasound + biopsy
PSA prior to DRE exam
IPSS questionnaire
Treatment
Drugs
Alpha blockers e.g.
tamsulosin
which decreases smooth muscle tone- side effects include drowsiness, depression, dizziness, low BP, dry mouth
5α reductase inhibitors e.g.
finasteride
- decreases testosterone conversion to dihydrotestosterone
Surgery
Transurethral incision of prostate (TUIP)
Prostatectomy
Transurethral resection of prostate (TURP)
Lifestyle
Relax when voiding
Void twice in a row to aid emptying
Avoid caffeine/alcohol
Bladder training