Benign prostatic hyperplasia (BPH)
Benign prostatic hyperplasia is a noncancerous (benign) growth of the prostate gland. Management of BPH depends on severity of symptoms according to International Prostate Symptom Score (IPSS)
Signs and Symptoms
• Weak, intermittent stream and urinary hesitancy
• Irritative (frequency, nocturia and urgency) voiding symptoms.
• Digital rectal examination reveals a uniform enlargement of the prostate.
• Urinary retention with a distended bladder may be present in the absence of severe symptoms, therefore it is important to palpate for an enlarged bladder during examination.
• Pelvic or transrectal uss confirms the prostate enlargement
• Prostatic specific antigen levels are within normal range
- Patients with moderate symptoms according to IPSS should be put under medical therapy unless opt for surgery.
Medical treatment of BPH includes alpha adrenergic blocker or 5 alpha reductase inhibitor or a combination of both Adrenergic Alpha Blockers:
• Tamsulosin (PO) 0.4 mg once daily
• Alfuzosin (PO) 10mg once daily 5-alpha Reductase Inhibitors
• Finasteride (PO) 5mg once daily
• Dutasteride (PO) 0.5mg once daily.
- • Patients with mild symptoms should be put under watchful waiting (change of life style and regular follow up)
• Patients with severe symptoms should undergo surgery, transurethral resection of the prostate for prostate weighing up to 75 gms and those weighing more than 75gms should undergo open prostatectomy
• For patients presenting with urinary retention, insert a urethral catheter as a temporary measure while patient is transferred to hospital
• Remove drugs that prevent urinary outflow e.g. tricyclics and neuroleptics.
All patients with BPH and associated commplications like recurrent UTI, Haematuria, renal insufficiency, hernia and urinary stones need surgery and should be referred to centres where specialized care can be offered.
23 Novemba 2020 12:22:13
I'm a paragraph. I'm connected to your collection through a dataset. Click Preview to see my content. To update me, go to the Data Manager.