Benign Prostatic Hyperplasia (BPH, Enlarged Prostate)

Posted by e-Medical PPT Wednesday, July 18, 2012
Understanding the prostate
Walnut-shaped gland that forms part of the male reproductive system
Surrounds the urethra - the tube that carries urine from the bladder out of the body
Secretes semen which carries sperm
The size of prostate enlarged microscopically since the age of 40.Half of all men over the age of 60 will develop an enlarged prostate
By the time men reach their 70’s and 80’s, 80% will experience urinary symptoms

What is Benign Prostatic Hyperplasia?
BPH is part of the natural aging process, like getting gray hair or wearing glasses
BPH cannot be prevented

What’s LUTS?
Voiding (obstructive)symptoms
Hesitancy
Weak stream
Straining to pass urine
Prolonged micturition
Feeling of incomplete bladder emptying
Urinary retention

Storage (irritative or filling) symptoms
Urgency
Frequency
Nocturia
Urge incontinence

LUTS is not specific to BPH – not everyone with LUTS has BPH and not everyone with BPH has LUTS

Diagnosis of BPH
Symptom assessment
the International Prostate Symptom Score (IPSS) is recommended as it is used worldwide
IPSS is based on a survey and questionnaire developed by the American Urological Association (AUA). It contains:
seven questions about the severity of symptoms; total score 0–7 (mild), 8–19 (moderate), 20–35 (severe)
eighth standalone question on QoL
Digital rectal examination(DRE)
inaccurate for size but can detect shape and consistency
PV determination- ultrasonography
Urodynamic analysis
Qmax >15mL/second is usual in asymptomatic men from 25 to more than 60 years of age
Measurement of prostate-specific antigen (PSA)
high correlation between PSA and PV, specifically TZV
men with larger prostates have higher PSA levels1
PSA is a predictor of disease progression and screening tool for CaP
as PSA values tend to increase with increasing PV and increasing age, PSA may be used as a prognostic marker for BPH
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