Benign prostatic hyperplasia (BPH) is a histopathological diagnosis characterized by epithelial cell & smooth muscle cell proliferation in the transition zone of the prostate leading to a non-malignant enlargement of the gland, which may result in lower urinary tract symptoms, including voiding and storage symptoms.
It is commonly called enlarged prostate.
Etiology is unknown but due to its similarity to the embryonic morphogenesis of the prostate has led to the hypothesis that BPH may be the result of "reawakening" in adulthood of embryonic induction processes.
Patients on watchful waiting should be assessed at 6 months and then annually, provided that there are no absolute indications for surgery and symptoms do not deteriorate
Patients on pharmacological therapy should be assessed to determine response to treatment and safety
Patients taking alpha blockers, anticholinergics, beta-3 adrenergic agonist, PDE5 inhibitors or combination therapy should be assessed at 4-6 weeks after drug initiation and then every 6-12 months thereafter
Patients taking 5-alpha reductase inhibitors should be assessed at 3-6 months after drug initiation and then every 6-12 months thereafter
Patients on 5-alpha reductase inhibitors should be monitored with annual DRE and PSA
Patients who underwent surgical therapy should be assessed 4-6 weeks after catheter removal to evaluate for treatment response and adverse events
No further reassessment is necessary in patients without adverse events and with symptomatic relief
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.