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