This document provides an overview of benign prostatic hyperplasia (BPH) management presented by Dr. Muhammad Ujjudud Musa. It discusses the surgical anatomy, pathology, history, examination, investigations, and various treatment options for BPH including watchful waiting, medical therapy, minimally invasive treatments, and surgery. Surgical treatments covered include transurethral incision of the prostate, transurethral resection of the prostate, and open prostatectomy. Post-operative care and complications are also reviewed.
BENIGN PROSTATIC HYPERPLASIA: Epidemiology, Etiology, Pathophysiology, and ev...Gagan Adhikari
This document discusses the embryology, anatomy, etiology, and pathophysiology of benign prostatic hyperplasia (BPH). It notes that BPH originates from the transition zone of the prostate and results from an increase in epithelial and stromal cells. The precise causes are unknown but factors discussed include aging, genetics, androgens, estrogens, impaired programmed cell death, and interactions between stromal and epithelial cells. Androgens are required for normal prostate development and maintenance but do not directly cause BPH; their role may involve inhibiting cell death.
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.
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.
This document discusses the etiology and pathophysiology of benign prostatic hyperplasia (BPH). It states that while androgens are required for normal prostate development, the precise causes of BPH are uncertain. Several factors may be involved, including androgens, estrogens, growth factors, inflammation and genetic factors. BPH causes prostate enlargement which obstructs the urethra. This obstruction induces changes in bladder function over time, leading to lower urinary tract symptoms. A variety of treatment options exist to relieve bladder outlet obstruction and manage symptoms.
This document discusses the management of urethral strictures. It defines urethral strictures and describes their etiology, including congenital causes and acquired causes like infection, inflammation, trauma, and iatrogenic factors. Treatment options for urethral strictures include instrumentation methods like dilation and internal urethrotomy as well as open reconstruction techniques like excision and anastomosis or substitution urethroplasty using grafts or flaps. The document provides details on various surgical techniques and factors that influence treatment outcomes.
1) Hydronephrosis is defined as the dilatation of the pelvi-calyceal system of the kidney due to partial or intermittent blockage of urine flow.
2) Causes include congenital abnormalities, kidney stones, ureteral strictures, or compression from other structures.
3) Treatment depends on the underlying cause and includes procedures to remove obstructions like stones, repair strictures, or decompress the system with nephrostomy tubes. Surgery may be needed for severe hydronephrosis to prevent kidney damage.
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: Epidemiology, Etiology, Pathophysiology, and ev...Gagan Adhikari
This document discusses the embryology, anatomy, etiology, and pathophysiology of benign prostatic hyperplasia (BPH). It notes that BPH originates from the transition zone of the prostate and results from an increase in epithelial and stromal cells. The precise causes are unknown but factors discussed include aging, genetics, androgens, estrogens, impaired programmed cell death, and interactions between stromal and epithelial cells. Androgens are required for normal prostate development and maintenance but do not directly cause BPH; their role may involve inhibiting cell death.
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.
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.
This document discusses the etiology and pathophysiology of benign prostatic hyperplasia (BPH). It states that while androgens are required for normal prostate development, the precise causes of BPH are uncertain. Several factors may be involved, including androgens, estrogens, growth factors, inflammation and genetic factors. BPH causes prostate enlargement which obstructs the urethra. This obstruction induces changes in bladder function over time, leading to lower urinary tract symptoms. A variety of treatment options exist to relieve bladder outlet obstruction and manage symptoms.
This document discusses the management of urethral strictures. It defines urethral strictures and describes their etiology, including congenital causes and acquired causes like infection, inflammation, trauma, and iatrogenic factors. Treatment options for urethral strictures include instrumentation methods like dilation and internal urethrotomy as well as open reconstruction techniques like excision and anastomosis or substitution urethroplasty using grafts or flaps. The document provides details on various surgical techniques and factors that influence treatment outcomes.
1) Hydronephrosis is defined as the dilatation of the pelvi-calyceal system of the kidney due to partial or intermittent blockage of urine flow.
2) Causes include congenital abnormalities, kidney stones, ureteral strictures, or compression from other structures.
3) Treatment depends on the underlying cause and includes procedures to remove obstructions like stones, repair strictures, or decompress the system with nephrostomy tubes. Surgery may be needed for severe hydronephrosis to prevent kidney damage.
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.
Priapism is a prolonged, often painful erection unrelated to sexual stimulation. The document defines and discusses the types, causes, pathophysiology, epidemiology, and treatment challenges of priapism. Specifically, it distinguishes between ischemic (low-flow) priapism caused by failure of venous outflow, and nonischemic (high-flow) priapism caused by unregulated arterial inflow. Sickle cell disease and medications are common causes and prolonged ischemia can lead to erectile dysfunction due to corporal fibrosis.
Priapism is a prolonged, unwanted erection that continues hours beyond sexual stimulation. There are two main types: ischemic (low-flow) priapism which is painful and involves little blood flow out of the penis, and non-ischemic (high-flow) priapism which is painless and involves an abnormal connection allowing high arterial inflow. Ischemic priapism is a medical emergency requiring aspiration of blood from the penis and injection of medications to induce detumescence within 4-6 hours to prevent permanent erectile dysfunction. Treatment options depend on duration and include aspiration, intracavernosal injections of medications, or surgical shunting if conservative measures fail.
TURP step by step operative urology series
for more resources:
www.uronotes2012.blogspot.com
enter your mail & press follow us by mail to receive our daily feeds
Urinary retention is the inability to empty the bladder completely. It can happen suddenly and be acute or last a short time, or it can be chronic. The main causes are obstruction of the urethra from conditions like enlarged prostate, strictures, or tumors, nerve problems from issues like diabetes or injury, certain medications, or weakened bladder muscles from aging. Men over 70 are most at risk. Evaluation involves history, exam, and bladder drainage initially via catheter. Long term treatment depends on the underlying cause but may involve surgery.
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.
This document provides an overview of obstructive uropathy. It begins by defining obstructive uropathy as the functional or anatomic obstruction of urine flow at any level of the urinary tract. It then discusses the prevalence of obstructive uropathy and how it can be classified based on factors like duration and site of obstruction. Potential causes of obstructive uropathy are then reviewed for different parts of the urinary tract. The pathophysiology and hemodynamic changes that occur with obstruction are explained. Cellular and molecular changes that can lead to fibrosis and tubular cell death are described. Management of patients is discussed including diagnostic imaging, issues in patient care like hypertension and pain management, and considerations for surgical intervention.
The correct answer is e. Hemodialysis is not associated with high-flow priapism. The other answer choices are all known causes or associations of high-flow priapism.
Hydronephrosis is the dilation of the renal pelvis and calyces caused by urinary outflow obstruction. It can result from anatomical or functional issues anywhere along the urinary tract. Chronic or severe hydronephrosis can lead to permanent kidney damage if not treated. Treatment depends on the cause and severity but may include ureteral stents, percutaneous nephrostomy tubes, or open surgery to bypass or remove the obstruction. The goal is to relieve obstruction and preserve kidney function.
This document provides an overview of hydronephrosis, including definitions, etiology, pathophysiology, clinical features, investigations, and management. Hydronephrosis is dilation of the renal pelvis or calyces that can be associated with obstruction. The causes include congenital issues like PUJ obstruction or acquired issues like ureteral strictures. Untreated obstruction can lead to renal damage through stages of compensation and decompensation. Clinical features depend on the cause but may include loin or groin pain. Investigations include imaging like ultrasound, IVU, CT scan, and urodynamics. Management involves relieving obstruction through surgery or stenting as well as treating infections.
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.
BPH is an enlargement of the prostate gland due to increased cell growth. Risk factors include aging, family history, and lifestyle factors like smoking, alcohol, and diet high in animal fats. Symptoms include difficulty urinating and frequent urination. Treatment involves medications to relax the bladder and prostate or surgical procedures to remove prostate tissue. Nursing management focuses on restoring urinary function, preventing infections, and educating patients.
This document outlines the evaluation and management of urolithiasis by the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the moderators, evaluation including history, examinations, imaging and laboratory tests. Management is covered including general measures, medical management, extracorporeal shock wave lithotripsy, endoscopic procedures like ureteroscopy and percutaneous nephrolithotomy, and open surgeries. Indications and complications of the different treatment methods are also provided.
This document discusses the management of epispadias, a birth defect where the opening of the urethra is on the upper side of the penis or clitoris. It first defines epispadias and discusses its embryology. It then describes signs and symptoms, classifications, and potential complications. The goal of surgical correction is to create a straight urethra to allow urination and prevent infections while maintaining erectile function and continence. For males, techniques like the Mitchell technique involve complete disassembly and reassembly of the penis. For females, early reconstruction can realign the clitoris and urethra opening. Surgery in infancy provides the best chance for a functional bladder long term.
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.
A nephrectomy is a surgical procedure to remove a kidney. There are several types including simple, partial, and radical nephrectomies. A surgeon must have knowledge of renal anatomy and vasculature. Approaches can be open, laparoscopic, or robotic. Key steps include mobilizing the kidney, isolating and ligating the renal vessels, and closing fascial layers. Complications include bleeding, fistula, and loss of renal function.
this presentation covers anatomy of the testis, embryological development, causes, clinical features, complications, differences between various types, investigations, and management of undescended testis.
Hydronephrosis is the dilatation of the renal pelvis and calyces caused by obstruction of urine flow from the kidney. It can be caused by congenital abnormalities, such as ureteral atresia, or acquired issues like kidney stones. On imaging, the kidney appears enlarged with a distended pelvis and thinning of the renal parenchyma. Treatment depends on the severity and cause of obstruction, ranging from nephrostomy or pyeloplasty for mild hydronephrosis to nephrectomy if the kidney is non-functioning.
The document provides information on the anatomy, microscopic anatomy, blood supply, nerve supply, and common conditions of the prostate gland such as benign prostatic hyperplasia. It discusses the procedure of transurethral resection of the prostate in detail, including preoperative considerations, choices of anesthesia, intraoperative monitoring, complications such as TURP syndrome, and their prevention and management. TURP syndrome is caused by excessive absorption of irrigating fluids and can lead to hyponatremia, hypervolemia, and other electrolyte abnormalities.
This document discusses various urethral and prostatic causes of hematuria and urinary symptoms. It covers urethral stones, tumors, benign prostatic hyperplasia, prostatitis, and prostate cancer. For each condition, it describes clinical features, investigations, and treatment approaches. Common complications include urinary retention, obstruction, and infection. Diagnostic tests include urine analysis, ultrasound, and biopsy. Management involves procedures like lithotripsy, transurethral resection of the prostate, and drugs.
Priapism is a prolonged, often painful erection unrelated to sexual stimulation. The document defines and discusses the types, causes, pathophysiology, epidemiology, and treatment challenges of priapism. Specifically, it distinguishes between ischemic (low-flow) priapism caused by failure of venous outflow, and nonischemic (high-flow) priapism caused by unregulated arterial inflow. Sickle cell disease and medications are common causes and prolonged ischemia can lead to erectile dysfunction due to corporal fibrosis.
Priapism is a prolonged, unwanted erection that continues hours beyond sexual stimulation. There are two main types: ischemic (low-flow) priapism which is painful and involves little blood flow out of the penis, and non-ischemic (high-flow) priapism which is painless and involves an abnormal connection allowing high arterial inflow. Ischemic priapism is a medical emergency requiring aspiration of blood from the penis and injection of medications to induce detumescence within 4-6 hours to prevent permanent erectile dysfunction. Treatment options depend on duration and include aspiration, intracavernosal injections of medications, or surgical shunting if conservative measures fail.
TURP step by step operative urology series
for more resources:
www.uronotes2012.blogspot.com
enter your mail & press follow us by mail to receive our daily feeds
Urinary retention is the inability to empty the bladder completely. It can happen suddenly and be acute or last a short time, or it can be chronic. The main causes are obstruction of the urethra from conditions like enlarged prostate, strictures, or tumors, nerve problems from issues like diabetes or injury, certain medications, or weakened bladder muscles from aging. Men over 70 are most at risk. Evaluation involves history, exam, and bladder drainage initially via catheter. Long term treatment depends on the underlying cause but may involve surgery.
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.
This document provides an overview of obstructive uropathy. It begins by defining obstructive uropathy as the functional or anatomic obstruction of urine flow at any level of the urinary tract. It then discusses the prevalence of obstructive uropathy and how it can be classified based on factors like duration and site of obstruction. Potential causes of obstructive uropathy are then reviewed for different parts of the urinary tract. The pathophysiology and hemodynamic changes that occur with obstruction are explained. Cellular and molecular changes that can lead to fibrosis and tubular cell death are described. Management of patients is discussed including diagnostic imaging, issues in patient care like hypertension and pain management, and considerations for surgical intervention.
The correct answer is e. Hemodialysis is not associated with high-flow priapism. The other answer choices are all known causes or associations of high-flow priapism.
Hydronephrosis is the dilation of the renal pelvis and calyces caused by urinary outflow obstruction. It can result from anatomical or functional issues anywhere along the urinary tract. Chronic or severe hydronephrosis can lead to permanent kidney damage if not treated. Treatment depends on the cause and severity but may include ureteral stents, percutaneous nephrostomy tubes, or open surgery to bypass or remove the obstruction. The goal is to relieve obstruction and preserve kidney function.
This document provides an overview of hydronephrosis, including definitions, etiology, pathophysiology, clinical features, investigations, and management. Hydronephrosis is dilation of the renal pelvis or calyces that can be associated with obstruction. The causes include congenital issues like PUJ obstruction or acquired issues like ureteral strictures. Untreated obstruction can lead to renal damage through stages of compensation and decompensation. Clinical features depend on the cause but may include loin or groin pain. Investigations include imaging like ultrasound, IVU, CT scan, and urodynamics. Management involves relieving obstruction through surgery or stenting as well as treating infections.
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.
BPH is an enlargement of the prostate gland due to increased cell growth. Risk factors include aging, family history, and lifestyle factors like smoking, alcohol, and diet high in animal fats. Symptoms include difficulty urinating and frequent urination. Treatment involves medications to relax the bladder and prostate or surgical procedures to remove prostate tissue. Nursing management focuses on restoring urinary function, preventing infections, and educating patients.
This document outlines the evaluation and management of urolithiasis by the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the moderators, evaluation including history, examinations, imaging and laboratory tests. Management is covered including general measures, medical management, extracorporeal shock wave lithotripsy, endoscopic procedures like ureteroscopy and percutaneous nephrolithotomy, and open surgeries. Indications and complications of the different treatment methods are also provided.
This document discusses the management of epispadias, a birth defect where the opening of the urethra is on the upper side of the penis or clitoris. It first defines epispadias and discusses its embryology. It then describes signs and symptoms, classifications, and potential complications. The goal of surgical correction is to create a straight urethra to allow urination and prevent infections while maintaining erectile function and continence. For males, techniques like the Mitchell technique involve complete disassembly and reassembly of the penis. For females, early reconstruction can realign the clitoris and urethra opening. Surgery in infancy provides the best chance for a functional bladder long term.
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.
A nephrectomy is a surgical procedure to remove a kidney. There are several types including simple, partial, and radical nephrectomies. A surgeon must have knowledge of renal anatomy and vasculature. Approaches can be open, laparoscopic, or robotic. Key steps include mobilizing the kidney, isolating and ligating the renal vessels, and closing fascial layers. Complications include bleeding, fistula, and loss of renal function.
this presentation covers anatomy of the testis, embryological development, causes, clinical features, complications, differences between various types, investigations, and management of undescended testis.
Hydronephrosis is the dilatation of the renal pelvis and calyces caused by obstruction of urine flow from the kidney. It can be caused by congenital abnormalities, such as ureteral atresia, or acquired issues like kidney stones. On imaging, the kidney appears enlarged with a distended pelvis and thinning of the renal parenchyma. Treatment depends on the severity and cause of obstruction, ranging from nephrostomy or pyeloplasty for mild hydronephrosis to nephrectomy if the kidney is non-functioning.
The document provides information on the anatomy, microscopic anatomy, blood supply, nerve supply, and common conditions of the prostate gland such as benign prostatic hyperplasia. It discusses the procedure of transurethral resection of the prostate in detail, including preoperative considerations, choices of anesthesia, intraoperative monitoring, complications such as TURP syndrome, and their prevention and management. TURP syndrome is caused by excessive absorption of irrigating fluids and can lead to hyponatremia, hypervolemia, and other electrolyte abnormalities.
This document discusses various urethral and prostatic causes of hematuria and urinary symptoms. It covers urethral stones, tumors, benign prostatic hyperplasia, prostatitis, and prostate cancer. For each condition, it describes clinical features, investigations, and treatment approaches. Common complications include urinary retention, obstruction, and infection. Diagnostic tests include urine analysis, ultrasound, and biopsy. Management involves procedures like lithotripsy, transurethral resection of the prostate, and drugs.
This document provides information about jaundice and obstruction of the biliary tract. It begins with an overview of the causes of yellow discoloration of the skin and mucous membranes, which is caused by bilirubin accumulation. It then describes the breakdown of red blood cells and how bilirubin is processed and excreted. The document outlines various causes of obstructive jaundice including gallstones, strictures, tumors, and external compression. Investigation methods and treatment approaches for different biliary obstructions are also summarized.
The document discusses prostate cancer and benign prostatic hyperplasia (BPH). It covers the incidence, risk factors, pathology, clinical findings, diagnosis and evaluations, as well as treatments for both conditions. For prostate cancer, it addresses staging and grading. It describes treatments for localized disease and recurrent disease after treatment. For BPH, it discusses symptoms, signs, tests, differential diagnosis, and medical and surgical treatment options.
A 55-year-old male was admitted with coughing blood for 4 days. He had a history of smoking for 25 years and a previous episode of coughing blood 3 months ago. Investigations revealed an aneurysm of the descending aorta measuring 5.3 cm in size that was leaking into the left lung and pleural cavity, causing the patient's symptoms. Thoracic aortic aneurysms are most commonly due to atherosclerosis and can cause symptoms through compression of nearby structures or rupture. Surgical repair is indicated for symptomatic or rapidly enlarging aneurysms over 5.5-6 cm in diameter.
This document summarizes benign prostatic hyperplasia (BPH). It finds that the incidence of BPH increases with age, affecting 20% of men aged 41-50 and over 90% of men over 80. Risk factors include genetics and race. BPH causes both obstructive symptoms like weak urinary stream and irritative symptoms like frequent urination. Treatment options range from watchful waiting for mild cases to drug therapies like alpha blockers and 5-alpha reductase inhibitors to surgical procedures like transurethral resection of the prostate. Minimally invasive procedures also exist like laser therapy, transurethral vaporization of the prostate, and transurethral needle ablation of the prostate.
brief lecture notes for 5th sem MBBS, on portal hypertension and varices. Introduction to portal hypertension and esophageal and gastric varices and management of variceal bleeding.
This document discusses several liver conditions including portal vein thrombosis (PVT), peliosis hepatis, and their associated features. It notes that PVT can be acute or chronic, and describes the clinical manifestations, imaging findings, and treatment approaches for each. Peliosis hepatis is characterized by multiple blood-filled cavities in the liver and has been associated with medications, transplantation, and certain infections. The pathogenesis of peliosis hepatis remains unknown.
The document discusses various types of pancreatic tumors including benign and malignant exocrine tumors as well as endocrine tumors. It provides details on:
- The embryology, anatomy, blood supply, nerve supply and functions of the pancreas.
- Classification systems for benign exocrine tumors such as serous cystic neoplasms, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms.
- Signs, investigations and management of insulinomas, which are the most common pancreatic endocrine tumors causing hypoglycemia.
Exocrine neoplasms of pancreas, Introduction: Fifth leading cause of deaths from cancer,
Aggressive tumor biology, Advanced stage of disease @ diagnosis, Lack of effective systemic therapies....
This document discusses benign prostatic hyperplasia (BPH) and its treatment. It begins with a case study of a 60-year-old male patient presenting with urinary difficulties. It then defines bladder outlet obstruction and discusses the pathophysiology and symptoms of BPH, including increased voiding pressures and residual urine. Treatment options covered include lifestyle changes, medications like alpha blockers and 5-alpha-reductase inhibitors, and procedures like transurethral resection of the prostate. Complications of treatment are also summarized.
This document provides an overview of gallbladder and bile duct anatomy, ultrasound techniques, and common abnormalities. It discusses the anatomy of the gallbladder and bile ducts. Key points include the normal sonographic appearance of the gallbladder and distinguishing features of various gallbladder abnormalities like stones, polyps, and wall thickening. It also reviews bile duct anatomy and variants, ultrasound technique, and pathologies that can cause bile duct dilation or wall thickening such as stones, cancer, and cystic diseases. Evaluation of both the gallbladder and bile ducts is important using ultrasound.
This document provides an overview of acute and chronic pancreatitis. Regarding acute pancreatitis, it defines the condition, discusses etiology, pathophysiology, clinical features, investigations, management, complications like pseudocyst, and outcomes. It emphasizes that acute pancreatitis is a biochemical diagnosis based on elevated serum amylase and lipase levels. For chronic pancreatitis, it defines the condition as irreversible progressive destruction of pancreatic tissue causing loss of exocrine and endocrine function and pain. Key investigations and treatments are also summarized.
1. This document presents a case report of a 75-year-old man undergoing transurethral resection of the prostate (TURP) and discusses considerations for perioperative care.
2. Regional anesthesia is preferred for TURP due to benefits like early detection of complications and reduced blood loss, though general anesthesia may be used if regional is contraindicated.
3. Close monitoring is needed during and after TURP to watch for potential complications like TURP syndrome caused by excessive fluid absorption, bladder perforation, hemorrhage, or hypotension from lithotomy positioning.
Benign prostatic hyperplasia (BPH) is a common condition among aging men that causes urinary symptoms. It involves the microscopic and macroscopic enlargement of the prostate gland. BPH arises from overgrowth of prostate cells in the transition zone and causes obstruction of the urethra. Common symptoms include difficulty urinating, frequent urination, and urgency. Diagnosis involves examinations, urine flow tests, and imaging. Treatment options range from medication to surgery. Prostate cancer is another common condition in aging men that can cause similar urinary symptoms. It involves the abnormal growth of cells in the prostate gland and has risk factors including age, family history, and diet. Diagnosis involves examinations, PSA tests,
This document discusses several unusual CT manifestations of common abdominal diseases:
1. Solitary rectal ulcer syndrome appears as a solitary linear ulcer on rectosigmoidoscopy in young patients with rectal bleeding.
2. Giant ulcers in the ileum and colon seen on CT in AIDS patients are caused by cytomegalovirus.
3. Ovarian torsion presents on CT as an adnexal mass rotated to the midline and contralateral side with deviation of the uterus and free fluid. The twisted vascular pedicle may also be seen.
4. Chemotherapy-induced pseudocirrhosis appears on CT as diffuse hepatic fibrosis without masses in patients receiving chemotherapy for cancer.
In this presentation, I discussed the various liver swellings- both cystic and solid swellings. Cystic lumps are Pyogenic liver abscess, Amebic liver abscess and hydatid cyst. Benign solid swellings are Hepatic adenoma, Focal nodular hyperplasia and Hemangioma. The malignant solid swelings are secondary carcinoma of the liver, primary Hepatocellular carcinoma and Hepatoblastoma.
Similar to Management of bening prostatic hyperplasia (20)
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
3. INTRODUCTION
When the hair becomes grey & scanty,
when the specks of earthly matter begin
to be deposited in the tunics of the artery
& when a white zone is formed @ the
margin of the cornea, @ this same
period the prostate gland usually- one
might perhaps say invariably- becomes
increased in size. (Sir Benjamin C.B
1783-1862).
Riolan recognized urinary obstruction
due to BPH in 17th Century, the
pathology credited to Virchow in 19th
Century.
4. INTRO CONTD.
BPH a fibromyoadenoma is the commonest dx
of the prostate-80%.
Not seen <20yrs 8% - < 40yrs 50%-57 to
60yrs & 90% - 80yrs.
Afflicted about 14M in the USA & 30M world
wide.
Presence of testis, androgen, oestrogen
imbalance, familial, genetic, nutritional &
metabolic factors incriminated
Stem cell & neoplastic theories, the DHT,
embryonic reawakening & non androgenic
testis secretory factor hypothesis offer some
explanations.
Microscopic, macroscopic & clinical divisions
of BPH.
6. SURGICAL ANATOMY
The Prostate gland arises from the primitive
urethra as a series of epithelial buds @
12weeks of embryonic life.
It lies behind the pubis symphysis separated by
pubo-prostatic ligaments, fibro-fatty & blood
vessels.
A cone shaped gland extends from the bladder
neck to the urogenital diaphragm surrounds the
prostatic urethra measures 3.5 * 2.5cm &
weight 18-26g.
Mc Neal classified prostate into 4 zones:
peripheral, central, transitional & pre-prostatic
zones
9. ANATOMY CONT.
Blood supply: middle & inferior rectal
arteries. Venous drainage to the prostatic
plexus to internal iliac vein.
venous plexus connect with valve less
vertebral veins through which ca may
spread.
Lymphatic drainage to internal iliac
vessels connect to sacral spinal vessels
Nerve supply: sympathetic &
parasympathetic
11. PATHOLOGY
Nodular hyperplasia with a variegated gross
appearance mainly in the peripheral zone separated by
a distant smooth cleavage plane from the pathological
capsule
Randall observed 8 gross configurations
{1} Simple bilateral lobe hypertrophy
{2} Posterior commissural
{3} Subcervical (Abarran’s lobe)
{4} Anterior commissural
{5} Subtrigonal (lobe of Home)
{6} Median
{7} Lateral & median
{8} Lateral & Subcervical
# The epithelial cells may be tall columnar, cuboidal or
flattened low cuboidal
May be arrange peripherally, show papillary infolding or
assume a cribriform pattern
# Both ductal & acinar epithelium appear to be involved in
12. PATHOLOGY CONT.
Franks identified types of nodules histologicaly:
stromal (fibrovascular), fibromuscular, muscular,
fibroadenoma & fibromyoadenoma.
Histological variants :postatrophy, basal
cribriform & atypical adenomatous hyperplasia,
sclerosing adenomas & stromal hyperplasia with
giant cells.
The capsule transmits the pressure to the
urethra which causes prostatism, Collin's knife is
used to incise the capsule to improves outflow
obstruction.
The hyperplastic nodes compress the periphery
to form the false capsule from which BPH can be
enucleated or resected.
16. PRINCIPLES OF MANAGEMENT
Patient selection the mode of therapy &
education about the disease
To identify the patient’s LUTS both symptomatic
& physiologic.
To establish the etiologic role of BPH to LUTS
To evaluate the necessity for & probability of
success & risks of various therapeutic approach
to these problems.
To present the results of these assessments to
the patient for an informed consent about mgt
recommendations & available alternatives
The clinical evaluation centres on an evaluation
of symptoms, signs, lab results, selected images
& endoscopic studies
The insidious symptoms are recognized by yes
answer to any of : Do you wake up to micturate,
slow urine flow or bothersome bladder
17. HISTORY
Age
Irritative (overactive) Symptoms
Obstructive (underactive) symptoms
Jepsen & Bruskewitz review of LUTS: Nucturia >
Urgency
Heamaturia
Urine retention
Recurrent UTI
Ureamia
IPSS
Boyarsky Symptom Index
Madsen Inversen Index
Maine Medical Assessment Index
30. WATCHFUL WAITING
IPSS < 8
Patients adequately assessed & Ca.
prostate R/o
DRE, Serum PSA, TRUS guided prostatic
biopsy.
Regular: IPSS, PFR, PSA, PVR, Abd USS
& DRE @ follow up.
Abandon when patient’s condition is
deteriorating
31. MEDICAL THERAPY FOR BPH
Ideal for those with IPSS < 19
ALPHA ADRENERGIC BLOCKERS: e.g.
Terrazosin & doxasoxin (long acting)
Tamulzosin & Alfuzosin
ANDROGEN SUPPRESION: e.g. Finesteride &
Episteride ( 5ARI) Zanoterone ( receptor
antagonist)
AROMATASE INHIBITORS : e.g. Atamestame
PHOSPHODIESTERASE INHIBITORS: e.g.
Tadalif
COMBINATION THERAPY: e.g. Sildenafil &
Alfuzosin
32.
33.
34.
35. MINIMALLY INVASIVE RX
The mgt of BPH is of timely importance to patients,
their spouses & relatives hence the development of
these techniques.
INDICATIONS: IPSS 8-19 & Pts with severe
symptoms but unfit for surgery.
CONTRAINDICATIONS:
{1} Recurrent heamaturia
{2} Refractory acute or chronic retension
{3} Bladder stone due to BPH
{4} Hydroureters & hydronephrosis
{5} Large diverticuli
{6} Renal insufficiency
{7} Recurrent UTI
36. AVAILABLE MI TECHNIQUES
High intensity focus ultrasound HIFU
Transurethral laser therapy TULIP: {a}Intestitial
laser coagulation of the prostate
{b}Holmium laser ablation of the prostate HoLAP
{c}Holmium laser resection of the prostate HoLRP
{d}Photoselective vaporisation of the prostate PVP
{e}Thulium laser resection of the prostateTmLRP
Hyperthermia & thermotherapy
Intraurethral stents
Transurethral needle ablation of prostate TUNA
Transurethral balloon dilatation
Laparoscopic simple prostatectomy
Transperineal botulium toxin injection
37. MIT CONTD.
Transurethral vaporisation of the prostate: is
done with a grooved roller ball electrode to
vaporises the prostate by T > 100^C
HoLRP: uses the resectoscope to push the
adenoma into the bladder & remove using tissue
morcellator.
HIFU: involves tissue ablation by inducing high T
90-100^C using a sonoblate probe.
Prostatic stents: temporary ( gold plated
prostakin) & permanent ( urolome ).
TUNA: high frequency radio waves are used to
achieve high T 120^C.
PVP: performed with the potassium titanyl
phosphate ( KTP) laser which is selectively
absorbed by hemoglobin resulting in the
vaporisation of intercellular water in the tissue
40. PRE OP PREP.
Correct Dehydration
Correct Anaemia
Correct Dyselectrolytemia
Catheterization
GXM
Urethroscopy
DRE, IPSS & Flow rate
Consent
IVFs for irrigation
41. SURGICAL OPTIONS
Transurethral incision of the prostate
TUIP
Transurethral resection of the prostate
TURP
Open prostatectomy
AIM: to relieve the outflow obstruction by
removal of the adenoma from the outer
shell of the compressed capsule
Cystoscopy is done
42. TRANSURETHRAL INCISION OF
THE PROSTATE (TUIP)
Small prostate with a tight bladder neck &
no middle lobe enlargement.
Post op PFR of > 18mls/sec
< 10% will develop retrograde ejaculation
10% relapse & require TURP.
43. TRANSURETHRAL RESECTION
OF THE PROSTATE (TURP)
Done with a curved wired electrode rigid
resectoscope.
It carve a passageway from the bladder after
which a 3-way Foley's catheter is inserted &
irrigation commenced.
Pt is discharged on 4DPO but may have
haemorrhage on the 10DPO.
Mortality is 1.5% & morbidity increase with
resection time > 90min.
Improve IPSS in 88% & PFR of 8- 18mls/sec in
85%.3.4% 5yrs failure rate
44. COMPLICATIONS OF TURP
Primary haemorrhage (5-15%)
Secondary haemorrhage
Urinary incontinence (0.8)
Urethral stricture (6%)
Sexual dysfunction (70%)
46. OPEN PROSTATECTOMY
INDICATIONS
Prostate > 50-70g
Large bladder diverticulum
Large hard calcium stones
Marked ankylosis of the hip or other hip
conditions preventing lithotomy position
Large inguinal hernia requiring concomitant
repair
47. OP CONTD.
CONTRAINDICATIONS
Small prostate
Severe co-morbidity
Difficulty access to the prostate from
scarring due to previous suprapubic surgery
TYPES
Retro pubic (millin’s) prostatectomy
Transversical prostatectomy
48. RETROPUBIC PROSTATECTOMY
Through a midline or transverse suprapubic
incision the prostatic capsule is open from
front behind the pubis.
Hyperplastic part removed & readily visible
vessels ligated.
Foley’s catheter inserted & the capsule
closed by sutures.
49. TRANSVESICAL PROSTATECTOMY
The bladder is open extraperitoneally & the adenoma
enucleated with finger.
Calculus or bladder diverticuli can be seen &
addressed.
Haemorrhage is controlled by tamponade & sutures @
5 & 7 o clock positions.
Foley’s or malecot catheter is inserted & balloon
inflated to it the prostatic fossa & bladder closed
around the catheter.
Post op irrigation with N/S, 2.5% Dextrose or glycine.
PFR > 20mls/sec, 0.4% failure rate, 21.7%
complications rate & < 2% mortality.
50. C0MPLICATIONS OF OP.
Haemorrhage
Clot retension
UTI
Epididymo-orchitis
Persistent vesico cutaneous fistula
Wound infection
Incontinence of urine
Impotence
Retrograde ejaculation
Infertility
Urethral stricture
Damage to the ureters
53. CONCLUSION
The Management of BPH have gone
to supersonic super high way of
advancement in medical technical
know how, which involves the
urologist, pathologist, radiologist & the
urodynamicist However whatever the
enigma is yet to be fully addressed.
54. REFERENCES
1.E.A Badoe, E. Archampong & J.T Rocha A. principles
& practice of surgery including pathology in the tropics
3rd edition, 2000.P 850- 867.
2. Charles V. Mann, R.C.G Russell, et al Bailey &
Love’s short practice of surgery, 22nd edition Chapman
& Hall Medical. 1997,P 970-978.
3.Sani A. Aji, Benign prostatic hyperplasia P 6,11 & 14.
4.Patric Walsh et al. Walsh- Cambell’s Urology, 8th
edition Elsever 2002 P 381, 391- 392.
5. Jack McAninch, Emil Tanagho, Smith’s General
Urology, 6th edition McGraw-Hill/Appleton & Lange
2003,P4,267.
6.Sam G. Graham et al, Glen’s Urologic Surgery,5th
edition Lippincott Williams & Wilkins publishers, 1998
P37.