BPH

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Author:
capnhue
ID:
146494
Filename:
BPH
Updated:
2012-04-27 22:30:31
Tags:
Regis University
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Description:
BPH
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  1. What makes up the stroma?
    • smooth muscle cells
    • fibroblasts
    • extracellular matrix proteins
    • *is the connective tissue that provides structural support to the prostate gland
  2. What does the prostatic secretion consist of?
    • simple sugars
    • prostate-specific antigens (PSA)
    • acid phosphate
    • *also make up 20-40% of the volume of ejactulate
  3. Fibroblast Growth Hormone (FGH)
    • bFGF, FGF7
    • polypeptides
    • stimulate cell division
    • stimulate growth
  4. Transforming Growth Hormone (TGH)
    • TF-B1, TGF-B2
    • polypeptides
    • inhibit cell division
  5. agonists/antagonist of α1-adrenergic receptors
    • agonists of α1-adrenergic receptors in prostate promote constriction of the prostatic urethra
    • antagonists promote relaxation of prostate smooth muscle, leading to opening of urinary bladder neck
  6. BPH complications
    • acute painful urinary retention (painful dilation of bladder w/inability to void)
    • persistent hematuria
    • overflow urinary incontinence
    • recurrent UTI due to stagnation of urine w/in bladder
    • bladder diverticula due to chronic bladder dilation
    • bladder stones
    • chronic renal failure from bladder outlet obstruction (BOO)
  7. Irritative symptoms result from:
    • bladder hypertrophy
    • bladder filling
    • urinary frequency
    • nocturia
    • urinary urgency
  8. Obstructive symptoms
    • caused by narrowing of bladder neck and incomplete emptying of bladder
    • difficulty initiating urination
    • decreased force of urinary stream
    • intermittency of stream
    • urinary hesitancy
    • feeling of incomplete bladder emptying
    • dribbling
  9. Urinalysis evaluates the prescence of:
    • hematuria
    • infection
    • glucosuria
    • ketonuria
    • renal disease
  10. Gold standard Surgeries for BPH
    • Open Prostatectomy
    • Transurethral Resection of the Prostate (TURP)
  11. Lifestyle Modifications
    • fluid restriction (1500-2000ml of fluid/day) restrict fluid at bedtime
    • avoid: caffine, alcohol, spicy foods
    • replace binge drinking w/moderate drinking
    • avoid meds: diuretics, decongestants, antihistamines, antidepressants
    • timed or scheduled voiding (bladder retention)
    • pelvic floor exercises
    • avoidance of constipation
    • use frequency & volume charts (diaries)
  12. Tamsulosin adverse effects
    • congestion
    • floppy iris syndrome
    • *discontinue tamsulosin prior to cataract surgery
  13. 5α-reductase inhibitors adverse effects
    • erectile dysfunction
    • decreased libido
    • gynecomastia
    • abdominal pain
    • asthenia
    • muscle weakness
  14. Prone to hypotension treat BPH with:
    • alfuzosin
    • tamsulosin
    • silodosin
  15. Symptoms of BPH
    • acute painful urinary retention
    • persistent hematuria
    • overflow urinary incontinence
    • recurrent UTI due to stagnation of urine w/in bladder
    • bladder diverticula due to chronic bladder dilation
    • bladder stones
    • chronic renal failure from bladder outlet obstruction (BOO)
  16. drug-drug interactions w/ α1- adrenergic antagonists
    • cimetidine (decreases metabolism of α1 increasing effect of α1)
    • diltiazem (decreases metabolism of α1 increasing effect of α1)
    • ketoconazole ( contraindicated)

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