Benign Prostatic Hypertrophy Overview

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Questions and Answers

What is the primary function of the prostate in the male reproductive system?

Producing secretions that are part of the ejaculate (correct)

Regulating urinary flow

Facilitating sperm production

Producing testosterone

At what age does benign prostatic hypertrophy (BPH) commonly begin to affect men?

30 years

60 years

40 years (correct)

50 years

Which of the following statements about benign prostatic hypertrophy (BPH) is true?

It is the most common benign neoplasm in men aged 40 and above. (correct)

It leads to decreased production of ejaculate.

It is often asymptomatic in all cases.

It is a malignant neoplasm affecting younger males.

What aspect of male physiology does BPH directly impact?

Prostate secretions in the ejaculate Signup and view all the answers

Which function is not associated with the prostate gland?

Sperm storage Signup and view all the answers

What is a common urinary flow rate indicative of potential urologic disorders?

< 10–15 mL/s Signup and view all the answers

Which of the following tests helps assess bladder emptying integrity?

Neurological examination Signup and view all the answers

What post-voiding residual (PVR) volume is indicative of possible urologic issues?

Greater than 50 mL Signup and view all the answers

An enlarged prostate is defined as being greater than what weight in grams?

15–20 g Signup and view all the answers

Which condition can cause decreased urinary flow rate similar to that seen in BPH?

Urethral stricture Signup and view all the answers

What procedure is performed to document the presence of prostate cancer?

Transrectal prostate needle biopsy Signup and view all the answers

Which imaging technique evaluates prostate size and determines the best surgical approach?

Transrectal ultrasound Signup and view all the answers

What finding can indicate a need for further intervention in a patient with an enlarged prostate?

Documented presence of prostate cancer Signup and view all the answers

What does transurethral cystoscopy primarily visualize?

The urethra and bladder Signup and view all the answers

In the context of prostate examinations, what is the purpose of a transrectal prostate needle biopsy?

To collect tissue samples for cancer diagnosis Signup and view all the answers

Study Notes

Benign Prostatic Hypertrophy (BPH)

BPH is the most common benign neoplasm in men aged 40 years or older.
It affects the prostate gland, which surrounds the urethra at the base of the bladder.
The prostate produces secretions that are part of the ejaculate.
BPH causes lower urinary tract symptoms (LUTS), which are a collection of obstructive and irritative voiding symptoms.

Epidemiology and Etiology

BPH presents as benign prostatic hyperplasia, a histological disease common in elderly men.
Prevalence increases with age.
About 50% of patients with the histological disease develop an enlarged prostate on digital palpation.
25% of patients experience clinical voiding symptoms.
Two major etiological factors are advanced age and androgen stimulation.
The adult male prostate is approximately 15-20g prior to age 40.
The testes produce 90% and the adrenal glands 10% of circulating testosterone.
Testosterone enters prostate cells, where 5α-reductase converts it to dihydrotestosterone (DHT).
DHT binds to a cytoplasmic receptor, causing changes in protein synthesis that promote prostate growth.
5α-reductase inhibitors (e.g., finasteride, dutasteride) decrease DHT production.

Prostate Tissue Types

The prostate consists of glandular (epithelial) and muscle (stromal) tissue.
Glandular tissue produces prostate-specific antigen (PSA).
Muscle tissue contracts around the urethra and bladder outlet, which can be stimulated by androgens.
Stromal tissue growth can be stimulated indirectly by estrogen, as testosterone converts to estrogen in peripheral tissues.

Pathophysiology

BPH causes LUTS due to static and dynamic factors.
Static obstruction involves enlargement of the prostate gland compressing the bladder neck.
Dynamic mechanisms include increased stimulation of α1-adrenergic receptors in the prostate, urethra, and bladder neck, causing smooth muscle contraction.
Detrusor muscle hypertrophy occurs in response to prolonged obstruction, making the bladder irritable and causing storage symptoms (e.g., urinary frequency, nocturia, urgency, incontinence).

Treatment

The goal of treatment is to reduce or eliminate obstructive and irritative LUTS, slow disease progression, preventing complications, and minimizing adverse effects.
Treatment options include:
- Watchful waiting: Effective for mild symptoms in some cases
- Medications: α1-adrenergic antagonists, 5α-reductase inhibitors, or combinations
- Surgery: Prostatectomy for advanced cases.

Other Diagnostic Tests and Considerations

Decreased peak and mean urinary flow rates, increased post-void residual urine, digital rectal exam (DRE), transrectal ultrasound (TRUS), and transurethral cystoscopy, are diagnostic tools
A 6-month minimum treatment duration may be needed to determine effects of medication
Patients may also be advised to stop smoking, lose weight, and avoid excessive intake of caffeine-containing beverages, sugar-sweetened drinks, and alcohol.
Prostate cancer may be a consideration when assessing patients with BPH
Consult with a medical professional for any concerns related to BPH.

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Description

This quiz covers Benign Prostatic Hypertrophy (BPH), the most common benign neoplasm in men over 40. It explores epidemiology, symptoms, and factors contributing to this condition. Test your understanding of the prostate's role and the implications of BPH on urinary health.