Physical Examination Suprapubic area for sign of bladder distension DRE: Prostate gland size, nodularity, masses, surface, tenderness, anal tone
investigations Laboratory tests: CBC U&E PSA Urine analysis Urine culture and sensitivity Uroflow meter Kidney-bladder Ultrasound TRUS biopsy
Medical Treatment The prostate gland consists of : Glandular tissue Fibromuscular tissue
Medical Treatment The prostate is rich in alpha receptors especially type 1a which are responsible for LUTS in those patient. So, blocking these receptors can decrease the resistance along the bladder neck, urethra and prostate
Alpha blockers Selective agents short-acting: prazosin, alfuzosin, and indoramin. long-acting: terazosin, doxazosin and slow-release (SR) alfuzosin. Non selective agents Phenoxybenzamine Partial selective agents Tamsulosin and silodosin.
Surgical management Indications: AUR failed voiding trials recurrent gross hematuria urinary tract infection. renal insufficiency secondary to obstruction. failure of medical therapy, a desire to terminate medical therapy financial constraints associated with medical therapy.