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MS3 - Renal/Urology > BPH > Flashcards

Flashcards in BPH Deck (15)
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1
Q

Pathophysiology of BPH

A

Inner (transitional layer of prostate affected
5α-reducatase converts testosterone to DHT
Increased DHT causes hyperplasia

2
Q

Presentation of BPH

A

Storage symptoms
Voiding symptoms
Bladder stones
UTI

3
Q

Storage symptoms

A

Nocturia
Frequency
Urgency
Overflow incontinence

4
Q

Voiding symptoms

A
Hesitancy
Poor stream
Terminal dribbling
Strangury - urinary tenesmus
Incomplete emptying - pis en deux
5
Q

PR findings for BPH

A

Smoothly enlarged prostate

Definable median sulcus

6
Q

Ix for BPH

A

U+Es, PSA
Urine dip and MCS
Transrectal US +/- biopsy
Urodynamics

7
Q

Conservative Mx of BPH

A

Reduce caffeine and EtOH
Double voiding
Bladder training

8
Q

Medical Mx of BPH

A

1st) Tamsulosin - α-blockers, relax smooth muscle

2nd) Finasteride - 5α-reducatase inhibitor

9
Q

Side effects of tamsulosin

A

Drowsiness
Hypotension
Depression
Weight gain

10
Q

Side effects of finasteride

A

Erectile Dysfunction

Excreted in semen (use condoms)

11
Q

Surgical Mx of BPH

A

TURP
TUIP - less risk to sexual function
Laser prostatectomy
Open retropubic prostatectomy

12
Q

TUIP

A

Transurethral Incision of Prostate

13
Q

Immediate TURP complications

A

Haemorrhage

TURP syndrome - large fluid absorption leading to hyponatraemia

14
Q

Early TURP complications

A

Haemorrhage
Infection
Clot retention

15
Q

Late TURP complications

A
Retrograde ejaculation
ED
Incontinence
Urethral stricture
Recurrence