Tuesday, March 9, 2010

Benign prostatic hyperplasia

Benign prostatic hyperplasia - Chronic


 


 

Definition  

A progressive, cellular proliferative abnormality of the epithelial and stromal tissue of the prostate gland that is primarily a quality of life disease.


 

Medical History  

* Aging

* Testis normal

* Dietary finding


 

Findings  

* Dysuria

* Hematuria

* Delay when starting to pass urine

* Incomplete urination

* Increased frequency of urination

* Large prostate

* Nocturia

* Poor stream of urine

* Post-micturition incontinence

* Urgent desire to urinate

* Urine stream interrupted


 

Tests  


 

Suspected benign prostatic hyperplasia  

* Prostate specific antigen measurement: A prostate specific antigen level of 2 ng/mL to 9 ng/mL is suggestive of benign prostatic hypertrophy .


 

Suspected benign prostatic hyperplasia  

* Urinalysis: Hematuria may be present in benign prostatic hyperplasia and other conditions associated with lower urinary tract symptoms in aging men .


 

Differential Diagnosis  

* Prostate cancer - Chronic

* Prostatitis

* Malignant tumor of urinary bladder - Chronic

* Urethral stricture

* Urinary tract infectious disease

* Neurogenic bladder

* Urolithiasis


 

Treatment  


 

Drug Therapy  


 

Lower urinary tract symptoms due to benign prostatic hyperplasia  


 

DOXAZOSIN MESYLATE  

Doxazosin 2 mg orally at bedtime for 1 week, 4 mg orally at bedtime for 1 week, then 8 mg orally at bedtime


 

TERAZOSIN HYDROCHLORIDE  

Terazosin 2 mg orally at bedtime for 1 week, 5 mg orally at bedtime for 1 week, then 10 mg orally at bedtime


 

ALFUZOSIN HYDROCHLORIDE  

Alfuzosin 10 mg orally once daily


 

TAMSULOSIN HYDROCHLORIDE  

Tamsulosin 0.4-0.8 mg orally once daily


 

SILODOSIN (Related toxicological information in ALPHA-ADRENERGIC BLOCKERS)  

Adults: 8 mg orally once daily with a meal


 


 

Lower urinary tract symptoms in men with benign prostatic hyperplasia and demonstrable prostatic enlargement  


 

FINASTERIDE (Related toxicological information in FINASTERIDE) - DOXAZOSIN MESYLATE  

Finasteride 5 mg orally once daily and doxazosin 2 mg orally at bedtime for 1 week, 4 mg orally at bedtime for 1 week, then 8 mg orally at bedtime


 

FINASTERIDE (Related toxicological information in FINASTERIDE)  

Finasteride 5 mg orally once daily


 

DUTASTERIDE  


 


 

Procedural Therapy  


 

Benign prostatic hyperplasia  

* Observation regimes: Watchful waiting is an acceptable alternative to active treatment in so far as the patient understands the risks and benefits of available treatments .


 

Benign prostatic hyperplasia  

* Transurethral resection of the prostate: Transurethral resection of the prostate is an appropriate surgical treatment for symptomatic benign prostatic hyperplasia and its complications .


 

Non-Procedural Therapy  


 


 

Benign prostatic hyperplasia  

* Lifestyle Measures

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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence