Benign Prostatic Hyperplasia (BPH) Lecture Notes

Vocabulary terms and definitions covering the diagnostics, symptoms, treatments, and complications of Benign Prostatic Hyperplasia (BPH).

Benign Prostatic Hyperplasia (BPH)

Noncancerous enlargement of the prostate gland characterized by hypertrophy of the cells (increase in the number of cells, not growth in the size of the cells).

Prostate-specific antigen (PSA)

A marker used in BPH diagnostics to rule out CA (cancer).

Kidney, ureter, and bladder x-rays (KUB)

A specific x-ray diagnostic used in renal and prostatic evaluation.

Intravenous Pyelogram (IVP)

A diagnostic procedure requiring bowel preparation, assessment of allergy information, and administration of fluids.

BPH Obstructive Symptoms

Hesitancy, weak stream, straining to void, incomplete bladder emptying, prolonged urination, and acute or recurrent urinary retention.

BPH Irritative Symptoms

Urgency, frequency, nocturia, and urge incontinence.

BPH Demographic Risk Factors

Increasing age and normal androgen status; an estimated $25\%$ of males $> 50$ years old have symptomatic BPH.

BPH Genetic Risk Factors

First-degree relatives of patients with early onset BPH have $4 \times$ the risk for development of the condition.

Alpha-1 Adrenergic Blockers

A class of medications including tamsulosin ($Flomax$), alfuzosin ($Uroxatrol$), doxazosin ($Cardura$), prazosin ($Minipress$), and terazosin ($Hytrin$).

Mechanism of Action: Alpha-1 Adrenergic Blockers

Relaxes smooth muscle of the bladder neck and prostatic urethra.

Side Effects: Alpha-1 Adrenergic Blockers

Orthostatic hypotension, dizziness, tiredness, ejaculatory dysfunction, rhinitis, and headache.

Hormonal Agents (BPH)

Medications such as finasteride ($Proscar$) and dutasteride ($Avodart$) used for BPH treatment.

Mechanism of Action: Hormonal Agents

Inhibits conversion of testosterone, resulting in a decrease in gland size and improvement of symptoms; requires $6$ months of therapy for maximal effects.

Side Effects: Hormonal Agents

Decreased libido, decreased volume of ejaculate, impotence, postural hypotension, and a reduction in serum PSA by $50\%$.

Transurethral resection of the prostate (TURP)

A surgical treatment option for Benign Prostatic Hyperplasia.

Transurethral needle ablation of the prostate (TUNA)

A surgical treatment modality for BPH.

Hydronephrosis

Upper urinary tract obstruction, which is a potential complication of BPH.

3-WAY Foley

A triple lumen catheter system used for irrigation, including components like an irrigation bag, drip chamber, and drainage bag.