The Symptoms of Benign Prostatic Hyperplasia - Research Paper Example

BPH Diagnosis and Treatment Case Study The Pathophysiology The symptoms of Benign Prostatic Hyperplasia (BPH) can be related to the obstructive component of the prostate or the secondary reaction of the bladder to outlet resistance. The obstructive component is divided into two: dynamic and mechanical obstruction. Mechanical obstruction may occur as the prostatic enlargement occurs and intrudes into the bladder neck or urethral lumen (Wein, 2012). The consequence is high bladder outlet resistance. Earlier, urologists referred to the three lobes of prostate particularly the two lateral lobes and the median. This was before the zonal classification of prostate. The vibrant of prostatic obstruction accounts for the variable nature of BPH symptoms experienced by patients (Kadmon, 2011). The prostatic stroma comprised of collagen and smooth muscle is rich with adrenergic nerve supply. Autonomic stimulation, therefore, sets the tone to prostatic urethra. Alpha-blocker therapy whenever administered helps to decrease the outlet resistance (Beckman & Beliveau, 2005). The irritating voiding complaints of BPH often result from the response of the bladder to increased outlet resistance. Obstruction in the bladder outlet causes detrusor muscle hypertrophy, hyperplasia, and collagen deposition. The latter, is seemingly the most likely responsible cause of decrease in bladder compliance (Rind, 2006). Remarkably, though, detrusor instability is a major factor as well. A detailed inspection reveals that thickened muscle bundles are perceived as trabeculationin in cystoscopic examinations. If unchecked, mucosal herniation ensues between the detusor muscles leading to the formation of Diverticular. The result is in fact the false Diverticular comprised solely of mucosa and serosa (Bushma, 2011). Common clear obstructive symptoms of BPH include hesitancy, reduced force in quality of the stream, sensation of an incomplete emptying of the bladder, double voiding, post void dribbling, and strain when urinating. Irritative symptoms include nocturia, urgency, and frequency (Rind, 2006). Overview of Case study and Diagnosis M.P. who is in mid 40s has his father already diagnosed with BPH, implying that he may develop the same. The condition is hereditary. He is overweight as much as he considers himself healthy probably because he has no evident allergies. His wife, who already sensed that M.P. could have been unhealthy, suggested that he seeks medical intervention. His urinary symptomatology includes difficulties in starting his stream of urine, irritation when urinating, nocturia, lower back, and pelvic discomfort. These symptoms warrant a closer clinical examination because they are actually the symptoms of BPH. In fact, M.P. has both the obstructive and irritative symptoms as discussed in the preceding section. His history given in the case does not show that M.P. suffered from any urethral instrumentation, trauma, or urethritis, which nullifies the possibilities that his condition may not be bladder neck contracture or urethral stricture. Treatment Options The pharmacokinetics is only provided where the therapy involves the use of medications. The section is blank where inapplicable particularly if therapy is a physical process. Therapy Mechanism of action PHARMAKOKINETICS 5α-Reductase inhibitors: Prazosin Inhibits conversion of testosterone to dihydrotestosterone. The drug affects the epithelial constituent of the prostate, resulting in a reduced size of the gland hence, improvement in symptoms. Absorption is 57%. Volume of distribution is 0.59 l/kg Plasma protein binding 92 %. Presystemic metabolism is 50% and metabolism is Hepatic. Renal Excretion is Read More