Transcript
  • 1. 1 | P a g e Benign Prostatic Hyperplasia (BPH) , Benign Prostatic Hyperplasia (BPH) - , , -, ... Androgens ( ) ( Castration) ( ) , (DHT), , 5- -2 (DHT) , ... ... ( Autocrine) (Paracrine) ... ( Receptors) Growth Factors ( ) (Transcription Signal) ... 10 ... ( Nodular Hyperplasia) 5 - ...

2. 2 | P a g e - Stretching or Irritation ( ) - , 40 25 % , , ( Dynamic) -1 (Hypertrophy) -1 -1 1A 1D 1A 1D 1A 1D (Poor Libido), (Irrectile Dysfunction), - (Urethera) (Symphysis Pubis) , ( ) 3. 3 | P a g e - , Incontinence of Urine ( ) (Residual Urine) (Chronic Urinary Retention) - , () - ( ) - 2 % ( Concentration) (Crystal Precipitation) - , - (Hematuria) (Acinar) - - 5- ( Finasteride) - , () (Detrusor Instability) 15 ( 300 ) (Detrusor Instability) , , , - 4. 4 | P a g e -1 ( -1 ) , - ( ) - 1D 1A 13.6% (Digital Rectal Examination) - (PSA) , ... , ... ... 1.5ng/m 5 - ... PSA ratio ... ... ... ... , ... ... 5. 5 | P a g e (Urinary Flow Rate) (Post-void Residual Urine Volume) 300 .. , , ( Intra Venous Pyelography) Transrectal Ultrasound Scanning(TRUS) , , (Urodynamics) , , , , , , 6. 6 | P a g e (Cystoscopy also called Urethrocystoscopy) - , Differential Diagnosis (Symptom scores), (Uroflowmetry), (Prostatic Volume on DRE or TRUS) .. (Biochemical) , , -, -, , , , - ( relax) , , , , - ( Retrograde Ejaculation) , 5 ... ( ) ( ), (Retrograde Ejaculation) 7. 7 | P a g e , ( ) Medical Treatment of BHP Finasteride 5 mg HS Dutasteride0.5 HS Tab FINAST Tab FINCAR Tab CONTIFLO Cap DURIZE Tab VELTRIDE Terazosinstart with 1 mh HS increase up to 10 mg Tab TERAPRESS Tab HYTRIN Tamsulosin 0.4 to 0.8 mg HS Tab URIMAX Cap DYNAPRES Tab VELTAM Tab ODCONTIFLO OD F Cap URIMAX F Tab VELTAM F Cap FINAST T Cap URIMAX F Tab VELTAM PLUS Cap DUTAS-T Alfuzosin10 mg HS Tab FLOTRAL Tab ALFUSIN D Doxazosin 1, 2 & 4 mg Dose 1to 8 mg HS Tab DOXACARD Tab DURACARD Herbal Cap Prostanorm HS = at bed time - - - , , , - - Retrograde Ejaculation ( ), Incontinence ( ) ( ) - (TURP) - 8. 8 | P a g e , (TUIP or TIP) - - (Open prostatectomy) , - - (Minimally invasive treatments) , -(Laser Surgery) ( - ) (Ablative Procedures) ( ) 9. 9 | P a g e (Enucleative Procedures) - - Holmium laser ablation of the prostate (HoLAP) Visual laser ablation of the prostate (VLAP) Holmium laser enucleation of the prostate (HoLEP) Photoselective vaporization of the prostate (PVP) , , , Transurethral microwave thermotherapy (TUMT) , Transurethral needle ablation (TUNA) , - (TUMT) ( ) 10. 10 | P a g e Prostatic stents , , 4-6 - (Irritate) (Decongestants or Antihistamines) 4-6 , , (), , , , - - (Saw Palmetto) - - (Ryegrass Extract) (Stinging Nettle Extract) 11. 11 | P a g e , , , , , - , , - 5-


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