Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that is common in aging men. It is caused by hormonal changes that lead to increased cell growth in the prostate, compressing the urethra and causing urinary symptoms. Treatment options range from watchful waiting for mild symptoms to medications and surgery for more severe cases. Transurethral resection of the prostate (TURP) is generally the gold standard surgical treatment, providing long-term relief but also risks side effects like retrograde ejaculation and erectile dysfunction.
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
This document provides an overview of benign prostatic hyperplasia (BPH) presented by Prof. Dr. Sherine Ragy. It discusses the gross anatomy of the prostate, zonal anatomy, vascular supply, pathophysiology including the role of androgens. It also covers the natural history, definitions, complications and diagnosis of BPH including history, IPSS scoring, examination, PSA, and additional investigations. Non-surgical and medical therapy options are summarized including watchful waiting, alpha-blockers, 5-alpha reductase inhibitors and plant extracts. Common alpha-blockers and their dosing are listed.
This document provides an overview of benign prostatic hyperplasia (BPH), including its definition, epidemiology, clinical manifestations, complications, differential diagnosis, evaluation, and management. BPH involves noncancerous enlargement of the prostate and commonly causes lower urinary tract symptoms. It predominantly affects older men. Evaluation involves assessment of symptoms, physical exam including digital rectal exam, and tests like prostate-specific antigen. Management includes watchful waiting, lifestyle changes, medications like alpha-blockers and 5-alpha-reductase inhibitors, and potentially surgery for severe or treatment-resistant cases. Screening for prostate cancer with PSA is not universally recommended.
Imperforate anus is a birth defect where the rectum is malformed, causing the anus to be missing or narrowed. It occurs in about 1 in 5,000 births. The cause is generally unknown, though some genetic factors are associated. Imperforate anus can occur alone or with other defects as part of a syndrome. Treatment depends on the severity but may involve surgery to open the intestines or repair the anus. Prognosis depends on the type, with low lesions generally having better bowel control outcomes than high lesions.
Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort associated with changes in bowel habits. Common symptoms include abdominal discomfort relieved with defecation, changes in stool frequency or form. Treatment depends on whether constipation or diarrhea predominates, and may include increased fiber, bulk forming laxatives, antispasmodics, or anti-inflammatory drugs. While the cause is unknown, theories include altered stress responses, low-grade inflammation, and changes in gut microbiota. Diet modifications and lifestyle changes can help manage symptoms.
Ureteropelvic junction obstruction by\ Eman Salman
It was used for student presentation in Urology course rotation
I Hope you find what is helpful for your knowledge ♥
The document discusses the assessment, investigations, and treatment of intestinal obstruction. It provides details on the history, physical examination, and various tests used to diagnose the cause of obstruction including blood tests, imaging like x-rays and CT scans. It then outlines supportive care measures and describes specific surgical treatments for different types of intestinal obstructions like resection of gangrenous bowel or hernia repair with bowel resection if needed.
This document provides information about testicular torsion, including:
- Testicular torsion occurs when the testicle twists around the spermatic cord, cutting off blood flow and requiring emergency surgery to untwist within 6 hours to save the testicle.
- It is most common in males under 25 and can be caused by an unattached "bell clapper" deformity allowing the testicle to twist easily.
- Symptoms include sudden severe pain in one testicle. Diagnosis involves physical exam and sometimes ultrasound, and treatment is always surgery to untwist and add sutures to prevent future twisting.
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
This document provides an overview of benign prostatic hyperplasia (BPH) presented by Prof. Dr. Sherine Ragy. It discusses the gross anatomy of the prostate, zonal anatomy, vascular supply, pathophysiology including the role of androgens. It also covers the natural history, definitions, complications and diagnosis of BPH including history, IPSS scoring, examination, PSA, and additional investigations. Non-surgical and medical therapy options are summarized including watchful waiting, alpha-blockers, 5-alpha reductase inhibitors and plant extracts. Common alpha-blockers and their dosing are listed.
This document provides an overview of benign prostatic hyperplasia (BPH), including its definition, epidemiology, clinical manifestations, complications, differential diagnosis, evaluation, and management. BPH involves noncancerous enlargement of the prostate and commonly causes lower urinary tract symptoms. It predominantly affects older men. Evaluation involves assessment of symptoms, physical exam including digital rectal exam, and tests like prostate-specific antigen. Management includes watchful waiting, lifestyle changes, medications like alpha-blockers and 5-alpha-reductase inhibitors, and potentially surgery for severe or treatment-resistant cases. Screening for prostate cancer with PSA is not universally recommended.
Imperforate anus is a birth defect where the rectum is malformed, causing the anus to be missing or narrowed. It occurs in about 1 in 5,000 births. The cause is generally unknown, though some genetic factors are associated. Imperforate anus can occur alone or with other defects as part of a syndrome. Treatment depends on the severity but may involve surgery to open the intestines or repair the anus. Prognosis depends on the type, with low lesions generally having better bowel control outcomes than high lesions.
Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort associated with changes in bowel habits. Common symptoms include abdominal discomfort relieved with defecation, changes in stool frequency or form. Treatment depends on whether constipation or diarrhea predominates, and may include increased fiber, bulk forming laxatives, antispasmodics, or anti-inflammatory drugs. While the cause is unknown, theories include altered stress responses, low-grade inflammation, and changes in gut microbiota. Diet modifications and lifestyle changes can help manage symptoms.
Ureteropelvic junction obstruction by\ Eman Salman
It was used for student presentation in Urology course rotation
I Hope you find what is helpful for your knowledge ♥
The document discusses the assessment, investigations, and treatment of intestinal obstruction. It provides details on the history, physical examination, and various tests used to diagnose the cause of obstruction including blood tests, imaging like x-rays and CT scans. It then outlines supportive care measures and describes specific surgical treatments for different types of intestinal obstructions like resection of gangrenous bowel or hernia repair with bowel resection if needed.
This document provides information about testicular torsion, including:
- Testicular torsion occurs when the testicle twists around the spermatic cord, cutting off blood flow and requiring emergency surgery to untwist within 6 hours to save the testicle.
- It is most common in males under 25 and can be caused by an unattached "bell clapper" deformity allowing the testicle to twist easily.
- Symptoms include sudden severe pain in one testicle. Diagnosis involves physical exam and sometimes ultrasound, and treatment is always surgery to untwist and add sutures to prevent future twisting.
Benign prostatic hyperplasia (BPH) is a common condition in aging men that involves enlargement of the prostate gland. It often causes bothersome lower urinary tract symptoms (LUTS) such as frequent urination and weak urine flow. BPH-LUTS refers to these urinary symptoms linked to an enlarged prostate. Treatment involves medications like alpha-blockers and 5-alpha-reductase inhibitors to shrink the prostate and relieve symptoms. For men with larger prostates or those where medications fail, surgery such as transurethral resection of the prostate (TURP) may be considered, though it carries risks like incontinence or sexual side effects.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
This document provides an overview of benign prostatic hyperplasia (BPH) including its etiology, pathology, clinical findings, and investigation. It notes that BPH begins as microscopic nodules in the transitional zone of the prostate that can grow and compress surrounding tissue. Common symptoms include urinary frequency, urgency, and nocturia. Evaluation involves assessment of lower urinary tract symptoms, digital rectal exam, urinalysis, post-void residual measurement, and in some cases urodynamic testing. BPH is a common condition among older men that results from changes in hormone levels and growth factors.
Surgical Management of Intestinal Obstruction Harsha Yadav
The document discusses the management of intestinal obstruction. It covers supportive management including nasogastric decompression and fluid/electrolyte replacement. Surgical management principles include managing the site of obstruction, distended bowel, and underlying cause. Specific surgical techniques are described for different types of obstructions including adhesions, intussusception, large bowel obstruction, and volvulus in the caecum or sigmoid. Dynamic obstruction management is also outlined for paralytic ileus and pseudo-obstruction.
This document defines interstitial cystitis (IC) and bladder pain syndrome (BPS) as chronic bladder pain and discomfort perceived to be related to the urinary bladder. It discusses the epidemiology, etiology, signs and symptoms, diagnosis, and treatment of IC/BPS. Regarding treatment, it emphasizes conservative therapies like behavioral modification, physical therapy, and oral medications first before more invasive options like intravesical therapies, cystoscopy, neuromodulation, or in rare cases, surgery. The goal is to avoid surgery if possible and use multiple simultaneous treatments for best outcomes.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland caused by changes in hormone levels as men age. It involves the proliferation of cells within the prostate and commonly causes urinary symptoms like frequent urination, weak urine stream, and incomplete emptying of the bladder. Diagnosis involves a digital rectal exam, urinalysis, and tests to evaluate urine flow and residual urine in the bladder. While not cancerous, BPH can lead to complications like urinary tract infections if left untreated.
Phimosis is the inability to retract the foreskin over the glans due to a contracted opening, while paraphimosis occurs when the foreskin cannot be replaced after retraction behind the glans. For paraphimosis, gentle compression is applied to reduce swelling before replacing the foreskin; if this fails, the tissue must be incised. Phimosis is treated with antibiotics and hot compresses. Follow-up care for both conditions should include circumcision once swelling subsides.
Benign prostatic hyperplasia - symptomes and treatmentAreej Abu Hanieh
BPH, or benign prostatic hyperplasia, is a non-cancerous enlargement of the prostate gland caused by changes in hormone balance and cell growth as men age. It occurs when the prostate blocks part of the urethra, causing problems with urination. Symptoms range from mild to serious and include frequent, urgent, and interrupted urination. Diagnosis involves exams, tests to check urine and rule out infection or cancer. Treatment options include lifestyle changes, medications like alpha-blockers to relax the prostate or 5-alpha-reductase inhibitors to shrink the prostate, and surgery for severe cases. While not cancer, left untreated BPH can damage the kidneys.
Benign prostatic hyperplasia (BPH) is a common condition in aging men where the prostate gland enlarges. This can cause lower urinary tract symptoms like frequent urination, weak urine stream, and urgency. BPH is caused by changes in hormone levels as men age and cannot be prevented. Treatment options include medications to shrink the prostate or relax muscles, heat therapies, and surgery. Transurethral resection of the prostate (TURP) is a common surgical procedure that uses an electrified loop to cut away prostate tissue through the urethra. Potential complications include bleeding, infection, and a condition called TURP syndrome if too much irrigating fluid is absorbed during surgery. Careful fluid
This document discusses prostatitis, an inflammation of the prostate gland. It describes the different classifications of prostatitis including acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Treatment options are provided for different types, including antibiotics for acute bacterial prostatitis and supportive care. Diagnostic tests like urinalysis, EPS examination, and imaging are also outlined.
Acute urinary retention is defined as the painful inability to void with relief after catheterization. It is caused by bladder outlet obstruction from conditions like benign prostatic hyperplasia, urethral stricture, or neurological impairment. Risk factors include older age, larger prostate size, and lower urinary flow rate. For management, watchful waiting is appropriate for mild symptoms while more severe or recurrent cases may require medical treatment with alpha blockers or 5-alpha-reductase inhibitors, or surgical options like transurethral resection of the prostate.
An anal fissure is a small tear in the anal lining that causes severe pain and bleeding during bowel movements. It is often caused by passing hard stool or straining during bowel movements. Symptoms include pain during and after bowel movements, bleeding, and visible cracks. Diagnosis involves visual examination, and treatment focuses on pain relief, increasing blood flow to promote healing, and surgery if it becomes chronic.
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that is common in aging men. BPH occurs when the prostate gland grows larger and squeezes the urethra, causing problems with urination. Symptoms include difficulty starting or stopping urination and frequent urination, especially at night. Treatment options depend on symptom severity and include medications to shrink the prostate or relieve symptoms, minimally invasive procedures such as transurethral resection of the prostate, and surgery for severe cases. Potential complications of treatment include retrograde ejaculation and temporary difficulty urinating.
The document outlines the treatment and management of peptic ulcer disease. For H. pylori-positive patients, it recommends triple therapy with a proton pump inhibitor, clarithromycin, and metronidazole or amoxicillin for 14 days. For H. pylori-negative patients, it recommends treatment with proton pump inhibitors or H2 receptor antagonists along with antacids. It describes surgical interventions for complications or treatment failure and recommends lifestyle changes and prophylactic treatment for high-risk patients to prevent ulcers.
This document provides information on gastroesophageal reflux disease (GERD). It defines GERD as the backflow of gastric contents into the esophagus due to a weak lower esophageal sphincter. Approximately 50% of the population suffers from GERD, which can range from mild intermittent symptoms to more severe manifestations. The document discusses the etiology, clinical manifestations, pathophysiology, diagnostic evaluation, medical management, and nursing management of GERD.
This document provides an overview of overactive bladder, including its definition, etiology, pathophysiology, symptoms, diagnosis, and treatment. It defines overactive bladder as a symptom complex of urgency, usually with frequency and nocturia, with or without incontinence, in the absence of infection or other obvious pathology. The pathophysiology involves detrusor overactivity due to various hypotheses like outflow obstruction, neurogenic mechanisms, and myogenic and urothelial mechanisms. Treatment involves behavioral therapy, drug therapy using antimuscarinics, neuromodulation techniques, surgery for refractory cases, and newer developments in drug delivery and mechanisms of action.
Pathophysiology of urinary incontinencedr.hafsa asim
Urinary incontinence is defined as the involuntary loss of urine, which is both a social and hygienic problem that can be objectively demonstrated. It occurs when the internal sphincter and urethral closure pressure are unable to withstand increases in intra-abdominal pressure due to reductions in the differences between intraurethral and intravesical pressures.
This document provides information about benign prostatic hyperplasia (BPH) from the Department of Urology at Government Royapettah Hospital and Kilpauk Medical College in Chennai, India. It discusses the pathology, pathophysiology, symptoms, examinations, investigations, symptom scores, and treatment options for BPH, including watchful waiting, medical therapy using various drugs, and surgical procedures like transurethral resection of the prostate. It provides details on specific drugs, procedures, risks, and indications for different treatment approaches. The moderators and their specialties are listed at the beginning.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that is common in aging men. It occurs when the prostate gland grows larger and compresses the urethra, causing problems with urination. BPH is thought to be related to changes in hormone levels as men age. Treatment options include watchful waiting for mild symptoms, medications like alpha blockers and 5-alpha reductase inhibitors, and surgery for more severe cases. Transurethral resection of the prostate (TURP) is generally considered the "gold standard" surgical treatment, though it carries risks of side effects. Postoperative care focuses on monitoring for complications and restoring normal urinary function.
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that occurs in many men as they age. It is caused by hormonal changes that lead to increased cell growth in the prostate. BPH causes compression of the urethra and urinary symptoms like frequent urination, weak stream, and incomplete emptying. Treatment options include watchful waiting for mild symptoms, medication to reduce symptoms, or surgery for more severe cases. Surgical options range from minimally invasive procedures to more invasive options like transurethral resection of the prostate (TURP).
Benign prostatic hyperplasia (BPH) is a common condition in aging men that involves enlargement of the prostate gland. It often causes bothersome lower urinary tract symptoms (LUTS) such as frequent urination and weak urine flow. BPH-LUTS refers to these urinary symptoms linked to an enlarged prostate. Treatment involves medications like alpha-blockers and 5-alpha-reductase inhibitors to shrink the prostate and relieve symptoms. For men with larger prostates or those where medications fail, surgery such as transurethral resection of the prostate (TURP) may be considered, though it carries risks like incontinence or sexual side effects.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
This document provides an overview of benign prostatic hyperplasia (BPH) including its etiology, pathology, clinical findings, and investigation. It notes that BPH begins as microscopic nodules in the transitional zone of the prostate that can grow and compress surrounding tissue. Common symptoms include urinary frequency, urgency, and nocturia. Evaluation involves assessment of lower urinary tract symptoms, digital rectal exam, urinalysis, post-void residual measurement, and in some cases urodynamic testing. BPH is a common condition among older men that results from changes in hormone levels and growth factors.
Surgical Management of Intestinal Obstruction Harsha Yadav
The document discusses the management of intestinal obstruction. It covers supportive management including nasogastric decompression and fluid/electrolyte replacement. Surgical management principles include managing the site of obstruction, distended bowel, and underlying cause. Specific surgical techniques are described for different types of obstructions including adhesions, intussusception, large bowel obstruction, and volvulus in the caecum or sigmoid. Dynamic obstruction management is also outlined for paralytic ileus and pseudo-obstruction.
This document defines interstitial cystitis (IC) and bladder pain syndrome (BPS) as chronic bladder pain and discomfort perceived to be related to the urinary bladder. It discusses the epidemiology, etiology, signs and symptoms, diagnosis, and treatment of IC/BPS. Regarding treatment, it emphasizes conservative therapies like behavioral modification, physical therapy, and oral medications first before more invasive options like intravesical therapies, cystoscopy, neuromodulation, or in rare cases, surgery. The goal is to avoid surgery if possible and use multiple simultaneous treatments for best outcomes.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland caused by changes in hormone levels as men age. It involves the proliferation of cells within the prostate and commonly causes urinary symptoms like frequent urination, weak urine stream, and incomplete emptying of the bladder. Diagnosis involves a digital rectal exam, urinalysis, and tests to evaluate urine flow and residual urine in the bladder. While not cancerous, BPH can lead to complications like urinary tract infections if left untreated.
Phimosis is the inability to retract the foreskin over the glans due to a contracted opening, while paraphimosis occurs when the foreskin cannot be replaced after retraction behind the glans. For paraphimosis, gentle compression is applied to reduce swelling before replacing the foreskin; if this fails, the tissue must be incised. Phimosis is treated with antibiotics and hot compresses. Follow-up care for both conditions should include circumcision once swelling subsides.
Benign prostatic hyperplasia - symptomes and treatmentAreej Abu Hanieh
BPH, or benign prostatic hyperplasia, is a non-cancerous enlargement of the prostate gland caused by changes in hormone balance and cell growth as men age. It occurs when the prostate blocks part of the urethra, causing problems with urination. Symptoms range from mild to serious and include frequent, urgent, and interrupted urination. Diagnosis involves exams, tests to check urine and rule out infection or cancer. Treatment options include lifestyle changes, medications like alpha-blockers to relax the prostate or 5-alpha-reductase inhibitors to shrink the prostate, and surgery for severe cases. While not cancer, left untreated BPH can damage the kidneys.
Benign prostatic hyperplasia (BPH) is a common condition in aging men where the prostate gland enlarges. This can cause lower urinary tract symptoms like frequent urination, weak urine stream, and urgency. BPH is caused by changes in hormone levels as men age and cannot be prevented. Treatment options include medications to shrink the prostate or relax muscles, heat therapies, and surgery. Transurethral resection of the prostate (TURP) is a common surgical procedure that uses an electrified loop to cut away prostate tissue through the urethra. Potential complications include bleeding, infection, and a condition called TURP syndrome if too much irrigating fluid is absorbed during surgery. Careful fluid
This document discusses prostatitis, an inflammation of the prostate gland. It describes the different classifications of prostatitis including acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Treatment options are provided for different types, including antibiotics for acute bacterial prostatitis and supportive care. Diagnostic tests like urinalysis, EPS examination, and imaging are also outlined.
Acute urinary retention is defined as the painful inability to void with relief after catheterization. It is caused by bladder outlet obstruction from conditions like benign prostatic hyperplasia, urethral stricture, or neurological impairment. Risk factors include older age, larger prostate size, and lower urinary flow rate. For management, watchful waiting is appropriate for mild symptoms while more severe or recurrent cases may require medical treatment with alpha blockers or 5-alpha-reductase inhibitors, or surgical options like transurethral resection of the prostate.
An anal fissure is a small tear in the anal lining that causes severe pain and bleeding during bowel movements. It is often caused by passing hard stool or straining during bowel movements. Symptoms include pain during and after bowel movements, bleeding, and visible cracks. Diagnosis involves visual examination, and treatment focuses on pain relief, increasing blood flow to promote healing, and surgery if it becomes chronic.
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that is common in aging men. BPH occurs when the prostate gland grows larger and squeezes the urethra, causing problems with urination. Symptoms include difficulty starting or stopping urination and frequent urination, especially at night. Treatment options depend on symptom severity and include medications to shrink the prostate or relieve symptoms, minimally invasive procedures such as transurethral resection of the prostate, and surgery for severe cases. Potential complications of treatment include retrograde ejaculation and temporary difficulty urinating.
The document outlines the treatment and management of peptic ulcer disease. For H. pylori-positive patients, it recommends triple therapy with a proton pump inhibitor, clarithromycin, and metronidazole or amoxicillin for 14 days. For H. pylori-negative patients, it recommends treatment with proton pump inhibitors or H2 receptor antagonists along with antacids. It describes surgical interventions for complications or treatment failure and recommends lifestyle changes and prophylactic treatment for high-risk patients to prevent ulcers.
This document provides information on gastroesophageal reflux disease (GERD). It defines GERD as the backflow of gastric contents into the esophagus due to a weak lower esophageal sphincter. Approximately 50% of the population suffers from GERD, which can range from mild intermittent symptoms to more severe manifestations. The document discusses the etiology, clinical manifestations, pathophysiology, diagnostic evaluation, medical management, and nursing management of GERD.
This document provides an overview of overactive bladder, including its definition, etiology, pathophysiology, symptoms, diagnosis, and treatment. It defines overactive bladder as a symptom complex of urgency, usually with frequency and nocturia, with or without incontinence, in the absence of infection or other obvious pathology. The pathophysiology involves detrusor overactivity due to various hypotheses like outflow obstruction, neurogenic mechanisms, and myogenic and urothelial mechanisms. Treatment involves behavioral therapy, drug therapy using antimuscarinics, neuromodulation techniques, surgery for refractory cases, and newer developments in drug delivery and mechanisms of action.
Pathophysiology of urinary incontinencedr.hafsa asim
Urinary incontinence is defined as the involuntary loss of urine, which is both a social and hygienic problem that can be objectively demonstrated. It occurs when the internal sphincter and urethral closure pressure are unable to withstand increases in intra-abdominal pressure due to reductions in the differences between intraurethral and intravesical pressures.
This document provides information about benign prostatic hyperplasia (BPH) from the Department of Urology at Government Royapettah Hospital and Kilpauk Medical College in Chennai, India. It discusses the pathology, pathophysiology, symptoms, examinations, investigations, symptom scores, and treatment options for BPH, including watchful waiting, medical therapy using various drugs, and surgical procedures like transurethral resection of the prostate. It provides details on specific drugs, procedures, risks, and indications for different treatment approaches. The moderators and their specialties are listed at the beginning.
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that is common in aging men. It occurs when the prostate gland grows larger and compresses the urethra, causing problems with urination. BPH is thought to be related to changes in hormone levels as men age. Treatment options include watchful waiting for mild symptoms, medications like alpha blockers and 5-alpha reductase inhibitors, and surgery for more severe cases. Transurethral resection of the prostate (TURP) is generally considered the "gold standard" surgical treatment, though it carries risks of side effects. Postoperative care focuses on monitoring for complications and restoring normal urinary function.
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that occurs in many men as they age. It is caused by hormonal changes that lead to increased cell growth in the prostate. BPH causes compression of the urethra and urinary symptoms like frequent urination, weak stream, and incomplete emptying. Treatment options include watchful waiting for mild symptoms, medication to reduce symptoms, or surgery for more severe cases. Surgical options range from minimally invasive procedures to more invasive options like transurethral resection of the prostate (TURP).
Benign prostatic hyperplasia (BPH) is a common condition in aging men that involves the noncancerous enlargement of the prostate gland. BPH can cause lower urinary tract symptoms by compressing the urethra. Treatment options include medications to shrink the prostate or relax the urethra, such as alpha-blockers and 5-alpha reductase inhibitors. Surgery is considered if medications do not provide relief or for men with more severe complications. Managing BPH aims to improve symptoms, prevent disease progression, and reduce the risk of future complications through watchful waiting, medications, or surgery if needed.
This document discusses benign prostatic hyperplasia (BPH). It begins with the anatomy of the prostate gland and defines BPH as non-malignant prostate tissue growth due to aging. Risk factors for BPH include increasing age and family history. Clinical evaluation involves history, physical exam including digital rectal exam, and testing like PSA and ultrasound. Treatment options range from lifestyle changes and medications like alpha blockers and 5-alpha-reductase inhibitors for mild-moderate BPH to surgical interventions like TURP for severe cases. The document provides details on evaluation and management approaches for BPH.
The document provides an overview of benign prostatic hyperplasia (BPH), including its definition, epidemiology, risk factors, signs and symptoms, pathophysiology, diagnosis, treatment options and recent advances. It discusses how BPH involves the non-cancerous enlargement of the prostate gland which can squeeze the urethra and cause problems with urination. Risk factors include aging, family history, ethnicity and lifestyle factors. Treatment involves lifestyle changes, medications like alpha-blockers and 5-alpha-reductase inhibitors, and surgeries for more severe cases.
The document discusses a 64-year-old man admitted with benign prostatic hyperplasia (BPH) and acute urinary retention who underwent a transurethral resection of the prostate (TURP). It outlines his medical history, examination findings, surgical procedure and post-operative care. Potential nursing diagnoses are also identified related to risks from the surgery and catheterization.
This document provides information about benign prostatic hyperplasia (BPH) and treatment options for an enlarged prostate. It discusses common symptoms of BPH, risk factors, evaluation and testing procedures. Treatment options covered include watchful waiting, medications, in-office therapies like TUMT and TUNA, and surgery. For each treatment, it provides details on how the procedure is performed, expected outcomes, advantages, and potential side effects to consider. The goal is to educate patients on understanding BPH and working with their doctor to select the most appropriate treatment based on their individual symptoms and risk factors.
The document summarizes benign prostatic hyperplasia (BPH), a common condition where the prostate gland enlarges with age. It describes the anatomy of the prostate, risk factors for BPH, potential symptoms including frequent urination, and diagnostic tests. Treatment options discussed include drug therapies, minimally invasive procedures like microwave therapy and surgery to remove obstructing prostate tissue. Post-operative nursing care focuses on airway, vital signs, pain management and preventing complications.
BPH is characterized by increased epithelial and stromal cells in the prostate transition zone. Symptoms include poor urinary flow, frequency, and urgency. Diagnosis involves history, DRE, urinalysis, uroflowmetry and cystometry. Treatment options include watchful waiting for mild symptoms, medical therapy with alpha-blockers and 5-alpha reductase inhibitors, and surgery for severe symptoms. Combination drug therapy provides the greatest reduction in long-term complications like urinary retention.
1. G.M. reports urinary symptoms including difficulty initiating urination, decreased urinary stream, occasional midstream stoppage, postvoid dribbling, nocturia, and daytime urinary frequency.
2. On physical exam, G.M.'s prostate is severely enlarged, firm, and rubbery.
3. Objective tests find elevated BUN and creatinine levels as well as a large post-void residual urine volume of 900mL, indicating urinary retention from bladder outlet obstruction due to BPH.
Common Urological Problems in Geriatric PopulationRamayya Pramila
Common urological problems in the geriatric population significantly affect quality of life. These include lower urinary tract symptoms from benign prostatic hyperplasia and overactive bladder, urinary tract infections, erectile dysfunction, and prostate cancer. Treatment involves addressing underlying causes, medications like alpha blockers and antimuscarinics, and procedures for severe cases. Managing incontinence, infections, and other issues in elderly patients requires close monitoring, tailored treatment, and attention to their unique needs.
The document summarizes information about the prostate gland and benign prostatic hyperplasia (BPH). It discusses the anatomy and function of the prostate gland. It describes how the size of the prostate increases with age due to BPH in many men. Common symptoms of BPH include frequent urination and weak urine stream. Treatment options for BPH include watchful waiting, medications, and surgery. The risk of prostate cancer also increases with age and it is a major health concern for older men.
The document discusses benign prostatic hyperplasia (BPH), including its anatomy, pathogenesis, epidemiology, clinical presentation, evaluation, and treatment. It describes how BPH results in both obstructive and irritative lower urinary tract symptoms. Evaluation involves medical history, physical exam including digital rectal exam and prostate size assessment, and testing like urinalysis and PSA. Treatment options discussed are medical therapies like 5-alpha reductase inhibitors and alpha blockers, as well as surgical procedures for larger prostates or cases that fail medical management.
This document provides an overview of prostate health and benign prostatic hyperplasia (BPH). It discusses the anatomy and function of the prostate gland. BPH is defined as non-cancerous enlargement of the prostate and its symptoms include frequent urination and weak urine flow. Risk factors include age and lack of exercise. Treatment options for BPH include watchful waiting, medications that shrink the prostate, minimally invasive procedures like microwave therapy, and surgeries such as transurethral resection of the prostate (TURP) and GreenLight laser therapy. GreenLight laser therapy uses a laser to vaporize prostate tissue and has benefits over TURP such as shorter hospital stays and catheterization time.
renal_and_prostate_diease-benign_prostatic_hyperplasia_module_2.pptAbdul Jabbar Arif
A 75-year-old man is experiencing urinary symptoms of nocturia, frequency, incomplete emptying, and straining. He has a history of recurrent urinary tract infections, a large bladder diverticulum, and pronounced prostatic enlargement. His symptoms have only modestly improved with medical treatment. The best approach is to refer him to a urologist for consideration of an open surgical procedure to address his prostate and bladder issues.
As a part of my M.Sc. Nursing course, I have prepared PPT on Bengin Prostate Hyperplasia, which is an important topic from clinical as well as exam point of view. I hope this material will be helpful to the prospect nursing student. However, refer books for the better understanding of the topic.
Benign prostatic hyperplasia (BPH) is a common condition in aging men that results from hyperplasia of the prostate gland. Key points:
- BPH results in lower urinary tract symptoms in about 10% of men affected by middle age due to prostate enlargement obstructing urine flow.
- Evaluation involves medical history, physical exam including digital rectal exam, and urinalysis. Management focuses on lifestyle changes and medications like alpha-blockers and 5-alpha-reductase inhibitors.
- Differential diagnoses include urinary tract infections and prostate cancer, which require further workup and monitoring. Most patients see improvement in symptoms with medical treatment but some may require referral for surgical management.
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2. 08/31/17 2
Benign Prostatic
Hyperplasia
Generalised disease of the
prostate due to hormonal
derangement which leads
to enlargement of the gland
(increase in the number of
epithelial cells and stromal
tissue)to cause
compression of the urethra
leading to symptoms
3. BPH
Proposed Etiologies
Cause not completely understood
Reawakening of the urogenital sinus to proliferate
Change in hormonal milieu with alterations in the
testosterone/estrogen balance
Induction of prostatic growth factors
Increased stem cells/decreased stromal cell death
Accumulation of dihydroxytestosterone, stimulation by
estrogen and prostatic growth hormone actions
4. 08/31/17 4
BPH facts
Occurs in 50% of men over 50 and in 80% of
men over 80 have BPH
BPH progresses differently in every individual
Many men with BPH may have mild
symptoms and may never need treatment
BPH does not predispose to the
development of prostate cancer
7. BPH
Pathophysiology
Slow and insidious changes over time
Complex interactions between prostatic urethral
resistance, intravesical pressure, detrussor
functionality, neurologic integrity, and general
physical health.
Initial hypertrophydetrussor decompensation
poor tonediverticula formationincreasing urine
volumehydronephrosisupper tract dysfunction
8. 08/31/17 8
Complications
Urinary retention
UTI
Sepsis secondary to UTI
Residual urine
Calculi
Renal failure
Hematuria
Hernias, hemorroids, bowel habit change
9. 08/31/17 9
Clinical manifestations
Voiding symptoms
decrease in the urinary stream
Straining
Dribbling at the end of urination
Intermittency
Hesitancy
Pain or burning during urination
Feeling of incomplete bladder emptying
10. 08/31/17 10
Clinical manifestations
Irritative symptoms
urinary frequency
urgency
dysuria
bladder pain
nocturia
incontinence
symptoms associated with infection
12. Other Relevant History
GU History (STD, trauma, surgery)
Other disorders (eg. neurologic,
diabetes)
Medications (anti-cholinergics)
Functional Status
14. AUA Symptom Score Sheet
Not at all
Less
than 1
time
in 5
Less
than
half the
time
About half
the time
More
than
half
the
time
Almost
always
Your
score
Incomplete emptying
Over the past month, how often have you had a sensation of not emptying your
bladder completely after you finish urinating?
0 1 2 3 4 5
Frequency
Over the past month, how often have you had to urinate again less than two hours after
you finished urinating?
0 1 2 3 4 5
Intermittency
Over the past month, how often have you found you stopped and started again several
times when you urinated?
0 1 2 3 4 5
Urgency
Over the last month, how difficult have you found it to postpone urination? 0 1 2 3 4 5
Weak stream
Over the past month, how often have you had a weak urinary stream? 0 1 2 3 4 5
Straining
Over the past month, how often have you had to push or strain to begin urination? 0 1 2 3 4 5
None 1 time 2 times 3 times 4 times
5 times
or more
Your
score
Nocturia
Over the past month, many times did you most typically get up to urinate from the
time you went to bed until the time you got up in the morning?
0 1 2 3 4 5
Quality of life due to urinary symptoms
Delighted Pleased Mostly satisfied
Mixed – about equally
satisfied and dissatisfied
Mostly
dissatisfied
Unhappy Terrible
If you were to spend the rest of your life with your
urinary condition the way it is now, how would you
feel about that?
0 1 2 3 4 5 6
Total score: 0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.
16. BPH
Danger Signs on DRE
Firm to hard nodules
Irregularities, unequal lobes
Induration
Stony hard prostate
Any palpable nodular abnormality
suggests cancer and warrants
investigation
17. Optional Evaluations and
Diagnostic Tests
Urine cytology in patients with:
Predominance of irritative voiding symptoms.
Smoking history
Flow rate and post-void residual
Not necessary before medical therapy but should be
considered in those undergoing invasive therapy or
those with neurologic conditions
Upper tract evaluation if hematuria, increased creatinine
Cystoscopy
18.
19. 08/31/17 19
PSA
Elevated levels of PSA
0 – 4 ng/ml
Prostatic pathology
Correlates with tumor mass
Some men with prostate cancer have
normal PSA levels
20. BPH SYMPTOMS
Differential Diagnosis
Urethral stricture
Bladder neck contracture
Carcinoma of the prostate
Carcinoma of the bladder
Bladder calculi
Urinary tract infection and prostatitis
Neurogenic bladder
21. BPH TREATMENT
INDICATIONS
Absolute vs Relative
Severe obstruction
Urinary retention
Signs of upper tract
dilatation and renal
insufficiency
Moderate symptoms
of prostatism
Recurrent UTI’s
Hematuria
Quality of life issues
22. Treatment Options
Mild to severe symptoms with little
“bother”
Manage with watchful waiting.
Risk of therapy outweighs the benefit of
medical or surgical treatment
Moderate to severe symptoms with
bother
Management options include watchful
waiting, medical management and surgical
treatment.
23. Therapy
Watchful waiting and behavioral modification
Medical Management
Alpha blockers
5-alpha reductase inhibitors
Combination therapy
Surgical Management
Office based therapy
OR based therapy
Urethral stents
24. Watchful Waiting and Behavioral
Modification
“is the preferred management technique in
patients with mild symptoms and minimal bother”
AUA score < 7,
1/3 improve on own.
25. Watchful Waiting and Behavioral
Modification
Decrease caffeine, alcohol )diuretic effect(
Avoid taking large amounts of fluid over a short
period of time
Void whenever the urge is present, every 2-3 hours
Maintain normal fluid intake, do not restrict fluid
Avoid bladder irritants to include dairy products,
artificial sweeteners, carbonated beverages
Limit nighttime fluid consumption
BPH symptoms can be variable, intermittent
27. Benefits
Convenient
No loss of work
time
Minimal risk
Disadvantages
Expensive
Drug Interactions
Must be taken every day
Manages the problem
instead of fixing it
medication
28. 08/31/17 28
Medical Management
Alpha adrenergic receptor blockers
promote smooth muscle relaxation in the prostate
Relaxation of the muscles facilitates urinary flow
Doxazosin (Cardura), Terazosin (Hytrin),
Tamsulosin (Flomax), Alfuzosin (Uroxatral)
Side effects: postural hypotension, dizziness,
fatigue,
Other problems can occur when pt is also taking
cardiac or other hypertensive drugs
29. Alpha-Adrenergic Blockers
Equal clinical effectiveness
Slight differences in adverse event profile
Orthostasis (lower in tamsulosin)
Ejaculatory dysfunction (higher in tamsulosin)
Decreased energy levels
Nasal congestion
Increase in CHF risk with doxazosin
Must titrate doxazosin and terazosin to
effective levels
30. 08/31/17 30
Medical Management
5 alpha reductase inhibitor ) finasteride: Proscar(
Reduce size of prostate gland by up to 30 %by up to 30 %
Blocks the enzyme of 5 alpha reductase which is
nec, for the conversion of testosterone to
dihydroxytestostersone
Regression of hyperplastic growth
Don’t work immediatelyDon’t work immediately
Small effect on symptom score and flow ratesSmall effect on symptom score and flow rates
31. 5-Alpha Reductase Inhibitors
Agents are effective and appropriate treatment for
patients with lower urinary tract symptoms and
demonstrable enlargement of the prostate.
Average prostate size is 30 cc’s. Original studies
showed benefit only in men with prostate sizes
greater than 50 cc’s.
32. 5-Alpha Reductase Inhibitors
Finasteride (Proscar) and Dutasteride (Avodart)
Less effective for relief of BPH symptoms
than alpha blockers
Adverse events include
Decreased libido
Worsened sexual function (erectile dysfunction)
decrease volume of ejaculation
Breast enlargement and tenderness
Reduces risk of urinary retention by 3%/year.
PSA must be doubled if screening for prostate
cancer
33. Combination Therapy
Concomitant use of alpha blockers and
5-alpha reductase inhibitors
Should be reserved for patients who
are at significant risk of progression
and adverse outcome
Poor surgical candidate
Patient wants to avoid surgery
Significant cost associated with dual
medications
34. 08/31/17 34
Medical Management
Herbal therapy –
saw palmetto fruit –
use to improve
urinary symptoms
and urinary flow
Problem with herbal
therapy – long term
effectiveness
36. Surgical Management
Office based therapies:
Transurethral microwave therapy (TUMT)
Transurethral needle ablation (TUNA)
Therapies are effective
or partially effective for
relieving the symptoms of BPH
Significant side effects/complications
associated with these treatments
have prompted a FDA warning
37. Surgical Management
OR based therapies
Open simple prostatectomy
TURP
Transurethral incision of the prostate
Laser photoselective vaporization of the
prostate (green light laser PVP)
Laser Prostatectomy
38. Surgical Management
Patients may select surgical treatment as initial
therapy if moderate or severe bother is present.
Patients who have developed complications of
BPH (i.e urinary retention, renal insufficiency,
recurrent UTI) are best treated surgically.
New surgical treatment have not demonstrated
better outcomes than TURP to date.
39. BPH TREATMENT
Surgical
Indicated for AUA score >16
Transurethral Prostatectomy(TURP): 18%
morbidity with .2% mortality. 80-90%
improvement at 1 year but 60-75% at 5 years
and 5% require repeat TURP.
Transurethral Incision of Prostate (TUIP): less
morbidity with similar efficacy indicated for
smaller prostates.
Open Prostatectomy: indicated for glands >
60 grams or when additional procedure
needed for suprapubic/retropubic approaches
41. the “gold standard”- TURP
Benefits
Widely available
Effective
Long lasting
Disadvantages
Greater risk of side
effects and complications
1-4 days hospital stay
1-3 days catheter
4-6 week recovery
42. possible side effects of
Greater than 5% risk of:
Irritative voiding symptoms
Bladder neck contracture
UTI
Risk of incontinence 1%
Decline in erectile function
65% of retrograde ejaculation
TUR syndrome (acute hyponatremia from free
water absorption)
Hemorrhage
Bladder spasms
TURP
43. 08/31/17 43
Preoperative Goals
Restoration of urinary drainage
Treatment of any urinary tract infection
Understanding of procedure,
implications for sexual functioning and
urinary control
44. 08/31/17 44
Preoperative care
Antibiotics
Allow pt to discuss concerns about
surgery on sexual functioning
Prostatic surgery may result in
retrograde ejaculation
45. 08/31/17 45
Postoperative Goals
No complications
Restoration of urinary control
Complete bladder emptying
Satisfying sexual expression
46. 08/31/17 46
Postoperative Care
Monitoring
Continuous irrigation & maintain catheter
patency
Blood clots and hematuria are expected for
the first 24-36 hours
After catheter is removed – check for urinary
retention and urinary stream
47. 08/31/17 47
TURP
Sphincter tone may be poor after
catheter is removed. Kegal exercise
pelvic muscle floor technique is
encouraged. Starting and stopping the
urinary stream is helpful.
Stool softeners to avoid straining
Sitting and walking for long periods
should be avoided
48. 08/31/17 48
Discharge planning
Catheter care
Managing urinary incontinence
Oral fluid intake – 2,000-3,000 cc per day
Observe for s/s of urinary tract infection
Prevent constipation
Avoid lifting
No driving or intercourse after surgery
49. 08/31/17 49
Surgical approaches for
prostatectomy
Retropubic
Midline abd. incision
Perineal
Incision between the
scrotum and anus
Suprapubic
Abdominal incision
52. Destroy prostate tissue with heat
Tissue is left in the body and is expelled
over time (called sloughing)
Transurethral Microwave Therapy (TUMT)
Transurethral Needle Ablation (TUNA®
)
Interstitial Laser Coagulation (ILC)
Water Induced Thermotherapy (WIT)
heat therapies
53. heat therapies
Benefits
Office treatments
Local anesthesia
Minimally invasive
Reduced risk of
complications as
compared to
invasive surgical
“TURP”
Disadvantages
Some symptoms will
persist for up to 3
months
Cannot predict who will
respond
May require prolonged
catheterization
54. possible side effects of
Urinary Tract Infection
Impotence
Incontinence
heat therapies
55. Laser Photoselective
Vaporization of the Prostate
(Laser PVP)
TURP-equivalent 7 year improvement in
symptom score and urination parameters
Decreased risk of bleeding and TUR
syndrome, otherwise similar adverse effect
profile
May be done on anti-coagulated patients
Editor's Notes
Medications address the desire we all have to find a “cure” to fix the problem. We all like a “quick and easy” solution.
They can, however, become less effective over time.
Studies have shown that people tend to become less careful about following directions regarding the dose and/or frequency of taking their medication.
Until recently, the only option we could offer patients for treatment of their symptoms was either an open abdominal surgical procedure, or a trans-urethral resection of the prostate.
Medications address the desire we all have to find a “cure” to fix the problem. We all like a “quick and easy” solution.
They can, however, become less effective over time.
Studies have shown that people tend to become less careful about following directions regarding the dose and/or frequency of taking their medication.
Medications address the desire we all have to find a “cure” to fix the problem. We all like a “quick and easy” solution.
They can, however, become less effective over time.
Studies have shown that people tend to become less careful about following directions regarding the dose and/or frequency of taking their medication.