Benign prostatic hypertropy BPH

• Facts:
  Enlargement of the prostate
  > 80% of men have BPH by age 80
  BPH MC occurs in central (periurethral) zone of the prostate
• History / PE:
  Obstructive symptoms (hestitancy, weak stream, incomplete emptying, bladder fullness)
  Irritative symptoms (nocturia, urge incontinence )
  Firm, smooth prostate on DRE
• Diagnosis:
  Enlarged, smooth, firm prostate (DRE)
  UA and urine culture (rule out UTIs)
  Abdominal U/S (assess for hydronephrosis )
• Treatment:
  Alpha blockers (eg. terazosin )
  5-alpha-reductase inhibitors (eg. finasteride )
  TURP or open prostatectomy for moderate to severe symptoms
• Complications:
  Urinary retention
  Hydronephrosis
  Recurrent UTIs
• Differential Diagnosis:
  1) Prostate cancer (unlikely to present with urinary symptoms because cancer starts from the peripheral part of the prostate)
  2) Urinary tract infection