Case 5: Benign Prostatic Hyperplasia – Flashcards

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question
Where is the prostate gland located?
answer
The prostate gland is located at the base of the bladder, completely encircling the urethra
question
What happens to the prostatic urethra as the prostate gland enlarges?
answer
The prostatic urethra becomes compressed leading to bladder outlet obstruction
question
What are some of the symptoms of BPH?
answer
Need to frequently urinate in small amounts, feeling of incomplete bladder emptying, slow urinary flow, hesitation, needing to void at night, and in extreme cases complete urinary retention
question
What are cases where prostate biopsy is recommended?
answer
If there is an elevation of PSA, or if there is nodularity of the prostate
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What should be included in the differential for BPH?
answer
Prostate cancer, urethral stricture, UTI, prostatitis, and neurological conditions
question
What is the definition of micturition?
answer
Physiologic act of voiding that involves contraction of the detrusor muscle and relaxation of the bladder neck and urinary sphincters
question
What are examples of the alpha-1 blockers that can be used to help relaxthe bladder neck and prostatic urethra?
answer
Alfuzosin, doxazosin, tamsulosin, terazosin, and silodosin
question
What is the enzyme that is responsible for converting testosterone to the more potent dihydrotestosterone?
answer
5 alpha reductase
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What is an example of a 5 alpha reductase inhibitor?
answer
Finasteride
question
What should be included in a physical exam when assessing for BPH?
answer
A digital rectal exam, and a UA and PSA should be ordered
question
What are some states that call for urgent urological intervention?
answer
Renal compromise, elevated creatinine, and a palpable bladder on physical exam
question
If medical management is not effective for BPH what is the surgical intervention that can be performed?
answer
Transurethral resection of the prostate, or TURP.
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