-IBIS-1.5.0-
tx
reproductive system
benign prostatic hypertrophy
diagnoses

definition and etiology

definition: Benign adenomatous hyperplasia of the paraurethral prostate gland typically seen in aging men and often responsible for various degrees of urinary obstruction.

etiology: Apparently, BPH is an almost universal phenomenon in men as they age, beginning at 45 years old and continuing until, by age 70, 90% of men have an enlarged prostate. Due to this enlargement BPH is the leading cause of urinary outflow obstruction in men.

Some suggest that BPH typically indicates low levels of male hormones. (Easley)

signs and symptoms

signs and symptoms:
Severity of obstruction does not correlate well to amount of enlargement of the prostate.

Gradual onset of:
• Urinary frequency.
• Urinary urgency.
• Nocturia.
• Hesitancy with decreased force of stream.
• Terminal dribbling.
• Sensation of incomplete emptying.
• Overflow incontinence or total retention.
• Burning on urination, chills and fever indicate infection has set in.
• Possibly palpable distended bladder.
• Enlarged, rubbery prostate on rectal exam often with loss of median sulcus.

lab findings:
Excretory urogram: (+) for BPH.
Post-voiding cystogram.
Cystoscopy.
• Labs due to infection and retention.
• Consider acid phosphatase studies and prostate-specific antigen to rule out cancer.

course and prognosis

Conventional treatment includes surgical removal of all or part of the prostate. Most patients improve significantly after treatment.

differential diagnosis

• Neurogenic bladder.
• Acute prostatitis.
• Chronic prostatitis.
• Carcinoma.
• Other obstructive pathology.


footnotes