- What BpH Means ???
فى البداية ايه الفرق بين ال Hypertrophy و ال Hyperplasia ؟؟؟
- Hypertrophy Means enlargement of the components without an increase in their numbers as happens with muscle fibres .
- Hyperplasia Means increase in the number of the components and this is typical of glandular enlargement.
طب ايه هى وظيفة البروستاتا ؟؟؟
1- أفراز وتخزين سائل البروستاتا واللى بيمثل 30 % من السائل المنوى ودا مسئول عن حركة الحيوانات المنوية بالاضافة أنه سائل قلوى بيحافظ على حيوية الحيوانات المنوية فى الوسط الحامضى للمهبل .
2- البروستاتا عبارة عن مجموعة من العضلات اللى بتساعد على قذف السائل المنوى .
Benign prostatic hyperplasia is nonmalignant ( noncancerous ) enlargement of the prostate gland .
- BPH IS unusual before the age of 45 .
- BPH affects about 40% of men After the age of 50 .
- 90 % of men over the age of 80 have BPH .
- In BPH the the prostate gland grows in size >>>>>
compress the urethra which courses through the center of the prostate. >>>>
This can impede the flow of urine from the bladder through the urethra to the outside. >>>>>>
urine to back up in the bladder (retention) .
اللى بيحصل ان حجم البروستاتا بيزيد فبتضغط على قناة مجرى البول وتعوق
سريان البول خلالها للخارج فالبول بيرجع تانى او يحصل ليه إحتباس فى المثانة .
What are the Symptoms of BPH?
- incomplete bladder emptying
- nocturia (the need to urinate two or more times per night)
- dribbling at the end of the urinary stream
- incontinence سلس البول
- the need to strain when urinating
- weak urinary stream
- sudden urge to urinate
- slowed or delayed urinary stream
- painful urination
How is BPH Diagnosed ?
1- prostate biopsy (small amount of prostate tissue is removed and examined for abnormalities)
2- prostate-specific antigen (PSA, a blood test for to check for cancer of the prostate)
Normal PSA Values
Age (years) | PSA Cut-off |
| 40-49 | 2.7 |
| 50-59 | 3.9 |
| 60-69 | 5.0 |
| 70-75 | 7.2 |
3- Ultrasound examination of the prostate may be used prior to surgery or if it will assist choice of medical therapy.
What are the Treatments for BPH ?
فى البداية تنصح المريض انه أول ما يشعر انه عاوز يتبول يدخل الحمام وكمان يعود نفسه يدخل الحمام على فترات حتى لو مش عايز وتنصحه كمان انه يحط أيدة فى مياة دافيه أثناء وجوده فى الحمام دا بيساعد كتير على تدفق البول وتنصحه برضه انه يبعد عن اى حاجة بتنرفزه ويكون دايما هادى .
1- Selective Alpha 1 Blockers .
doxazosin, prazosin, terazosin, and tamsulosin.
A) Doxazosin : As in Cardura , Dosin
B) Prazosin : As in Minipress
C) Terazosin : As in Itrin , Prostasin
D) Tamsulosin : As in Tamsulin , Tamsul , Block Alpha , Omnic
Note : Tamsulosin is the more selective one as it acts on Alpha 1a Receptor .
Recently Eva pharma had Launched Flopadex for Treatment Bph .
Flopadex Contains silodosin which is 14 times more selective than Tamsulosin .
2- 5-alpha reductase inhibitors :-
block the synthesis of dihydrotestosterone (DHT) from testosterone and can reduce symptoms .
The prostate enlargement in BPH is directly dependent on DHT .
these drugs lead to an approximate 25% reduction in prostate size over 6 to 12 months .
Example : Finasteride ( proscar 5 mg )
3- Surgery : commonly in men who have not responded to medication .
