benign prostatic hyperplasia (BPH) presentation

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1. BENGIN PROSTATE HYPERPLASIA (BPH) Muhannad al- R abaty MSC. pharmaceutics

2. Introduction It is a condition progressive enlargement of prostate gland, resulting from an increase in the number of size of epithelial cells and stromal tissue.

3. Etiology Ageing Excessive accumulation of prostatic androgen Family history Diet increase animal fat and saturated faty acids Reduced exercise and alcohol consumption

4. Continue.. Recent studies have identified smoking (both current and former smoking), heavy alcohol consumption, hypotension, heart disease and diabetes mellitus as risk factors associated with BPH.

5. PATHOPHYSILOGY The cause of BPH is uncertain, but studies suggest that estradiol levels may have a relationship to prostate size among men with testosterone levels above the median.

6. The hypertrophied lobes of prostate may obstruct the vesical neck or prostatic urethra, causing incomplete emptying of the bladder and urinary retention. As a result. A gradual dilation of the ureters ( hyroureter ) and kidneys ( hydronephrosis ) can occur.

7. Signs and symptoms Obstructive Reduced force of urine stream Difficulty in initiating voiding Intermittency Dribbling at the end of urination

8. Sings and symptoms Frequency Urgency Dysuria Bladder pain Nocturia (excessive urination at night) Incontinence

9. Inflammation and infection sensation that the bladder has not been completely emptied. Generalized symptoms include Fatigue Anorexia Nausea and vomiting Epigastric discomfort

10. Complications Acute urinary retention Urinary tract infections (UTI) Renal stone (kidney stone) Bladder damage Hydronephrosis Pyelonephritis

11. Assessment and diagnostic findings

12. Medical management The main goals of medical management: Restore bladder function Relive signs and symptoms and prevent and treat complications.

13. Pharmacologic therapy Pharmacologic therapy include: Alpha adrenergic blocker and 5-alpha reductase inhibitors this type of medications relax the smooth muscle of the bladder neck and prostate. The smooth muscle blockade improves urine flow and relives BPH symptoms.

14. Alpha blockers (BPH) Tamsulocin (Omni cocas) tablet and capsule (0.4mg) ones daily Alfuzocin ( xatral ) (10 mg) ones daily after meal. Terazosin (1, 2, 5, 10 mg) two-three times daily Doxazocin (Cardura) (1, 2, 4, 8 mg) ones daily.

15. 5-alpha reductase inhibitors Dutasteride (Avodart) 0.5 mg ones daily Finasteride ( P roscar) 5 mg ones daily