BPH

Question 1

zonal anatomy of the prostate (4)

Answer 1

1. transition zone
2. central zone
3. peripheral zone
4. anterior fibromuscular stroma

Question 2

what zone surrounds the urethra?

Answer 2

transition zone

Question 3

which zone gives rise to BPH?

Answer 3

transition zone

Question 4

what zone surrounds the ejaculatory ducts?

Answer 4

central zone

Question 5

most (____)cancers arise from which zone?

Answer 5

70%; peripheral zone

Question 6

obstructive (voiding) sx assc’d with BPH (4)

Answer 6

1. weak stream
2. intermittent flow
3. straining to urinate
4. incomplete emptying

Question 7

irritative (storage) sx assc’d with BPH (3)

Answer 7

1. frequency
2. urgency
3. nocturia

Question 8

what can be a sign associated with BPH?

Answer 8

hematuria

Question 9

what converts free testosterone to DHT?

Answer 9

5 alpha reductase

Question 10

utilizations of DRE for BPH

Answer 10

1. estimate size of prostate
2. assess for prostate nodule suspicious for cancer rectal mass
3. assess anal sphincter tone

Question 11

what is the normal size of the prostate?

Answer 11

20 gr

Question 12

what is decision to tx BPH based on?

Answer 12

patients level of bother and willingness to comply with tx

Question 13

what is the target of alpha antags in tx of BPH

Answer 13

relaxes prostate and bladder neck smooth muscle tone

Question 14

which alpha antags are selective? (3)

Answer 14

1. alfuzosin
2. tamulosin
3. silodosin

Question 15

MOA: prevents conversion of testosterone to DHT

Answer 15

1. finasteride

2. dutasteride

Question 16

what did the MTOPS trial show?

Answer 16

combo tx more effective in reducing BPH progression

Question 17

absolute indications for surgery (5)

Answer 17

1. acuter urinary retention
2. recurrent uti
3. refractory gross hematuria
4. bladder stones
5. azotemia

Question 18

what is the gold standard surgery for BPH

Answer 18

transurethral resection of prostate (TURP)