• Pathophysiology
    • 🍒The middle transition zone are involved in the development of BPH
    • Bladder outlet obstruction leads to:
      • Detruser overactivity → irritative symptoms of BPH
      • Weakening of the bladder wall → incomplete voiding → urinary stasis → predisposition to Urinary Tract Infection (UTI)
      • Increased intracystic pressure while voiding → detrusor muscler hypertrophy → bladder trebeculation and pseudodiverticula formation
  • Symptoms
    • 🍒As a brief overview, the symptoms of BPH can be categorised into irritative symptoms and obstructive symptoms
    • 🍒What are the symptoms of BPH?
    • 🍒What would you expect to find on DRE examination for BPH?
  • Diagnostics
    • History to evaluate likely cause of LUTS:
      • Medications (e.g. diuretics, anticholinergics)
      • History of bladder, urethral or spinal injury/surgery
      • Presence of any neurological symptoms including sexual dysfunction
    • Instruct patient to keep a voiding diary
      • Includes a urinary frequency-volume chart and additional information (e.g. fluid intake, interference with sleep and frequency of urinary incontinence)
    • [ ] Various special investigations (not bothered at the moment to look through this)
  • Management

    • Nonpharmacological therapy

      • Review of medications
      • Dietary advice
      • Education about bladder emptying techniques
      • 🍒What is the nonpharmacological management of benign prostatic hypertrophy?

    • Pharmacological therapy

      Untitled

      • 🍒Antimuscarinics should be used in caution for the management of BPH in patients with post void residual volume >250 mL
      • 🍒What is the preferred medication to manage BPH with LUTS caused by bladder outlet obstruction?
      • 🍒What is the preferred medication to manage BPH with LUTS caused by overactive bladder?
      • 🍒What is the preferred medication to manage BPH with LUTS associated with erectile dysfunction?

    • Surgery

      • Transurethral resection of the prostate (TURP)
        • 🍒What are the perioperative complications of the TURP procedure?
        • 🍒What are the late complications of the TURP procedure?
        • 🍒The most common long-term sequelae of TURP is retrograde ejaculation
        • Antibitoic prophylaxis is with gentamycin