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Sunday, March 27, 2011

BENIGN PROSTATIC HYPERTROPHY

This is most commonly found in men over 60 and may be associated with diminished androgen secretion.
Histologically the inner zone of the gland undergoes hyperplasia and hypertrophy and there is an increase in fibromuscular stroma. The enlarged prostrate obstructs the outflow of urine by compressing, displacing, distorting and elongating the prostatic urethra with the effects on bladder and renal function.
Clinical features
These are those progressive obstruction to urinary flow. Acute urinary retention may arise. if the gland suddenly increases in size because of superimposed infection or congestion, or if cardiac failure develops in the elderly. Then the patient has a sudden desire to micturate but is unable to do so, and the bladder becomes tense and tender. Chronic retention may pass unnoticed for some time but there is a gradual increase in the volume of urine which remains in the bladder after micturition. Haematuria and urethral bleeding may also occur and may be the presenting symptom. On rectal examination the prostrate may feel large, elastic and uniform in consistency . When the median lobe is affected the prostate feels normal and the condition can be recognised only by cystoscopy. Transurethral resection of prostatic tissues is the treatment of choice to relive the outflow obstruction.

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