Summary of urological conditions and surgery. Covers clinical features, risk factors/causes, relevant diagnostic features and investigations and management guidelines for all the conditions.
Cross referenced with passmed/zero to finals/NICE guidelines - relevant for medical school finals
Microsoft Office User
[COMPANY NAME] [Company address]
, BENIGN PROSTATIC HYPERPLASIA
EPIDEMIOLOGY AND AETIOLOGY PATHOPHYSIOLOGY
Aetiology unknown, dihydrotestosterone required – Hyperplasia of the stroma and epithelium of the
converted from testosterone by 5-alpha reductase transition zone of the prostate. Tone of the smooth
Age-related muscle also plays key role
Extremely common Increase in proportion of the transition zone volume
o 50% of 50 year olds compared to the total prostate volume increase in
o 80% of 80 year olds BOO increased LUTS
PRESENTATION
Can be voiding symptoms or storage symptoms or INVESTIGATIONS
mixed History
Voiding symptoms LUTS assessed using IPSS
Bladder diary
Obstructive LUTS: hesitancy, straining, poor
Relevant PMHx – CCF, CKD, CVA, spinal injury,
stream, incomplete emptying, intermittency,
pelvic surgery, medication, alcohol
terminal dribbling
Decreased urine flow rate Examination
Impaired detrusor contractility and outflow DRE
obstruction Abdomen – palpable bladder
Storage symptoms Neuro examination
Frequency Urinalysis to exclude UTI
Urgency Bloods – UEs, PSA
Urine flow studies and PVT
COMPLICATIONS AND RELATED
CONDITIONS
Acute urinary retention (palpable bladder)
Haematuria
Hydronephrosis and renal compromise
UTI
Bladder stones
MANAGEMENT
Conservative/lifestyle
Watchful waiting
Lifestyle changes: alcohol/caffeine restriction, evening fluid restriction, avoid cold environment,
optimisation of other medical conditions
Management
Alpha antagonists: tamsulosin, alfuzosin
5-alpha reductase inhibitors: finasteride/dutasteride
Anti-cholinergics: for associated storage symptoms – no evidence of increase in AUR if no previous AUR
Mirabegron (beta-3 adrenergic agonist) for storage LUTS
AEs: retrograde ejaculation, dizziness, postural hypotension, headache, nasal congestion, ED, asthenia
(weakness), reduced libido (5-alpha reductase inhibitors)
Surgical
Aims to remove obstructing prostate transitional zone adenoma, with cauterising loop or laser
TURP – trans-urethral resection of the prostate – removed with cauterising loop
Laser prostatectomy – either Ho Laser enucleation of the prostate, or KTP prostatectomy
AEs: retrograde ejaculation (dry ejaculation) in 75%, ED in 10%, long-term UI in 1%
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller saskiahogan. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.73. You're not tied to anything after your purchase.
