7. •Pathophysiology of Benign Prostatic Hypertrophy
•Prostate growth
•Increased urethral resistance
•Decreased force of stream and intermittency, primarily
obstructive symptoms
•Detrusor response to maintain flow
•Frequency, urgency, and nocturia, primarily detrusor (failure
to store) symptoms
8. LUTS Symptom Group
-Frequency
-Poor stream
-Straining to void
-Hesitancy
-Intermittency
-Sensation of incomplete evacuation
-Dribbling
-Urgency
-Nocturia
9.
10.
11.
12.
13.
14.
15.
16.
17.
18. Natural History Of Benign Prostatic Hyperplasia
1-Histological prevalance-
30%at the age of 50 years
80% at the age of 80 years
2-IPSS Score >7
12% -26% at the age of40-49 years
46% at the age >70 years
3-Likelihood of treatment
3/1000 person-years at the age 40-49 years
30/1000 person-years at the age >70 years
4-Progression of disease over 5 years
37%-40%
5-Risk of urinary retention over 5 years
3%-7%
19. Candidates For Medical Therapy
1- Moderate to severe symptoms
2- Lack of absolute indications for surgery
Recurrent urinary retention
Recurrent or persistent gross hematuria
Bladder stones
Renal insufficiency
