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Benign Prostate Hyperplasia

(BPH)
Background
significant
disability
elderly
BPH men
infrequent
cause of
death

Predictive risk factors


associated with chance
8% in 40% to > 80%
of developing urinary
retention include age,
men 50% in in men
symptoms, urinary flow
aged 31 men older rate, and prostate size
to 40 aged than
years 51 to age 80
60 years
years
Etiology

Stromal and
epithelial
proliferation
in the
prostate
gland
Pathophysiology and clinical
manifestation
Androgen Prostatic
Testosteron
dehydrotestosteron enlargement
5 α Reductase (DHT)

Restrict the flow of


Decreased urinary urine from the
stream, urgency, bladder
hesitancy, Obstructive
intermittency, and a voiding
sense of incomplete symptoms
Natural
emptying
Irritative
History
voiding
symptoms
frequency, nocturia,
disuria , urgency
Diagnosis differential
• Urethral stricture
• Bladder neck contracture
• Carcinoma of the prostate
• Carcinoma of the bladder
• Bladder calculi
• Urinary tract infection and prostatitis
• Neurogenic bladder
Diagnosis
SCORING BY AMERICAN UROGICAL ASSOCIATION
Physical examination
Digital Rectal Examination
Inspect the sacrococcygeal and Examine the anus and rectum.
perianal areas
DIGITAL RECTAL GRADING
Additional examination
• Prostate spesific antigen (PSA)
– Normal PSA : 4ng/ml
– Mild Enlargement : 4-10ng/ml
– Moderate enlargement : 20 ng/ml
– Severe enlargement :20-35 ng/ml
• Ultrasonography suprapubic
• Cystoscopy
• Urinalisis