Please enable JavaScript.
Coggle requires JavaScript to display documents.
BPH ((DHT implication), Benign Prostatic Hypertrophy, Noncancerous,…
BPH
DHT implication
Benign Prostatic Hypertrophy
Noncancerous
enlargement of prostate constricts bladder causing urinary retention
25% males over age 40 and 75% males over age 70
phytotherapies are plant-based, herbs, berries, saw palmetto that are not recommended but often used to reduce the size of the prostate
hormones have unwanted side effects and are used to prevent the conversion of testosterone to DHT which is the hormone implicated
two hormones are finasteride and ditasteride and unwanted SE are decreased libido, ejaculation dysfunction, erectile dysfunction, gynomastia
alpha-adrenergic blockers are silodosin, tamsulosin, alfuzosin, terazosin which relax the bladder neck, allow urine to flow more easily, and act as vasodilators; these keep the vessels open, lower BP, and keep norepinephrine from tightening muscles in walls of smaller arteries and veins
Why Do We Manage Medically? To treat symptoms and improve QOL. We treat with pharmacological and surgical tx.
Focused Assessment includes are you a candidate for surgery, family hx, general health, previous surgical procedures
Tests and Exams include DRE (digital rectal exam), Urinalysis, PSA prostate should feel nontender and rubbery, prostate specific antigen rules out cancer, and urine checked for WBC, blood, UTI
Three types of surgical tx include TUMT, TUNA, TURP: TUMT transurethral microwave theraphy uses heat to slough off; TUNA uses needle ablation; TURP uses prostate resection in those with UTIs and endoscope removes it/check output and post op bleeding, other complications? Go hm same day
affects all races equally
slow development due to spasticity, resistance
risk factors include obesity, diabetes, high fat diet, low activity level, HTN, comorbidities, smoking, alcohol, lifestyle and habits
prostate enlargement=overflow incontinence
urinary frequency, dribbling, decreased force of stream, urgency, UTIs, hesitancy, nocturia, decreased volume, abdominal straining, incomplete emptying, thick, spongy, compressed
hx, physical exam, DRE, estimate size, symmetry, consistency
In BPH, prostate is symmetrically enlarged, firm, smooth
obstructive symptoms include decrease in caliber and force of stream, difficulty initiating voiding, intermittency, dribbling due to urinary retention
irritative symptoms are caused by inflammation and infection and cause urinary frequency, urgency, dysuria, bladder pain, nocturia, incontinence
AUA symptom index assesses voiding symptoms associated with obstruction to determine the degree of symptoms, but is not diagnostic