Benign prostatic hyperplasia

Benign prostatic hyperplasia

1. It affects the prostate

   • Anatomy of the prostate
     • Blood supply
       • Arterial
         • Inferior vesical
         • Middle rectal
         • Internal pudendal
       • Venous
         • Prostatic plexus
         • Vesical plexus
         • Internal iliac
     • Lobes
       • Anatomical
         • Median
         • 2 Lateral
       • Surgical
         • Anterior
         • Posterior
         • Median Lobe
         • 2 lateral
     • Zones
       • Central zone
       • Peripheral zone
       • Anterior lobe is fibromuscular
       • Transition zone

2. Physiology of micturition

3. Increased number of cells of the prostate, to be specific, the transitional zone (median lobe) of the prostate.

4. Causes

   • Aging process (Androgen receptors)
   • Increased DHT
   • Changes in cell growth factors

5. Signs and symptoms

   • Intermittency
     • Urgency
       • Nictoria
         • Emptying incomplete
           • Urethral obstruction
             • Mechanical: BPH and urethral stricture
             • Functional: Shy bladder syndrome (Paruresis)
           • Bladder: detrusor muscle areflexia or impaired centricity
             • Neurological disease damaging the detrusor muscle.
             • Sensory: Diabetic neuropathy
         • Weak stream
       • Straining
     • Frequency
       • UTI
         • Diabetes
           • Pregnancy
             • Enlarged prostate
               • Diuretic usa

6. Risk factors

   • Age
     • Family history
       • Lifestyle

7. Staging

   • Ti
     • T2
       • T3
         • T4
           • Invading other organs
         • Local extraprostatic extension
       • Palpable or visible cancer
     • Clinically inapparent lesion (Impalpable and not by emaging)

8. Complications

   • UTI
   • Stones
   • Kidney damage
   • urinary retention
     • Obstructive
       • BPH
         • Tumors and cancers
           • Urethral stricture
     • Non-obstructive
       • Stroke
         • Vaginal childbirth
           • Nerve diseases

9. Investigations

   • Urodynamic tests
     • Filling Cystometry
       • Electromyography
     • Uroflowmetry
       • Pressure-flow urodynamic studies

10. Management

    • Alpha blockers
      • 5-alpha reductase inhibitors
        • Combination drug therapy.
          • Tadalafil (Cialis)

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