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BENIGN PROSTATIC HYPERPLASIA
Terms in this set (17)
What is another name for benign prostatic hyperplasia?
What is BHP?
Disease of elderly men (average age is 60 to 65 years); prostate gradually enlarges, creating symptoms of urinary outflow obstruction
What is the size of a normal prostate?
20 to 25 gm
Where does BPH occur?
Periurethrally (Note: prostate cancer occurs in the periphery of the gland)
What are the symptoms?
Obstructive-type symptoms: hesitancy, weak stream, nocturia, intermittency, UTI, urinary retention
How is the diagnosis of BPH made?
History, DRE, elevated PostVoid Residual (PVR), urinalysis, cystoscopy, U/S
What lab tests should be performed?
Urinalysis, PSA, BUN, CR
What is the differential diagnosis?
-Prostate cancer (e.g., nodular)—biopsy
-Neurogenic bladder—history of neurologic disease
-Acute prostatitis—hot, tender gland
-Urethral stricture—RUG, history of STD
What are the treatment options?
- Pharmacologic— α-1 blockade
- Hormonal— antiandrogens
- Surgical— TURP, TUIP, open prostate resection
- Transurethral balloon dilation
Why do α-adrenergic blockers work?
1. Relax sphincter
2. Relax prostate capsule
What is Proscar®?
Finasteride: 5- -reductase inhibitor; blocks transformation of testosterone to dihydrotestosterone; may shrink and slow progression of BPH
What is Hytrin®?
Terazosin: α-blocker; may increase urine outflow by relaxing prostatic smooth muscles
What are the indications for surgery in BPH?
Due to obstruction: Urinary retention Hydronephrosis UTIs Severe symptoms
What is TURP?
TransUrethral Resection of Prostate: resection of prostate tissue via a scope
What is TUIP?
TransUrethral Incision of Prostate
What percentage of tissue removed for BPH will have malignant tissue on histology?
Up to 10%!
What are the possible complications of TURP?
Immediate: Failure to void Bleeding Clot retention UTI Incontinence
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