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BPH & Prostate Cancer.pdf

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University of Alberta

BPHProstate Cancer Benign Prostatic Hyperplasia BPHcondition where the prostate gland enlarges and gradually extends upward into the bladder and obstructs the outflow of urine Manifestationsincomplete emptying of the bladder and urinary retention gradual dilation of ureters hydroureter and kidneys hydronephrosisUTI from urinary stasis DiagnosticsProstate is large rubbery and nontenderProstate specific antigen PSA to rule out cancerIrritative and obstructive symptom complex prostatism o Increased frequency of urination nocturia urgency hesitation in starting urination abdominal straining with urination decrease in volume and force of urine stream dribbling sensation bladder is not completely emptied acute urinary retention recurrent UTIGeneralized symptoms o Fatigue anorexia nausea vomiting epigastric discomfort Digital rectal exam DREUrinalysis urodynamic studies to assess urine flowRenal function tests creatinine Medical Management Pharmacologic therapyAlphaadrenergic blockers o ie terazosin doxazosin tamsulosin o relax smooth muscle of bladder neck and prostatesmooth muscle blockade improves urine flow and relieves BPH symptoms o Alfuzosin extended release also exerts effect on posterior urethra5alphareductase inhibitors o ie finasteride o prevent conversion of testosterone to dihydrotestosterone DHTdecreased glandular cell activity and prostate size o side effects gynecomastiabreast enlargement ED flushing o may reduce risk of prostate cancerHerbal products Saw palmetto o From fruit of American dwarf palm tree o Similar to finasterideinterfere with conversion to DHT
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