Download Free Medical Benign Prostatic Hypertrophy BPH PowerPoint Presentation

Benign Prostatic Hypertrophy BPH PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Benign hyperplasia of Prostate gland is very common and well known diseases in elderly male. this is nothing but the old age urinary outlet irritative and may be some time obstructive pathology which clinically manifested by increase frequency of urination along with dysuria and some time may be retention of urine.

Tags : dr. panchal vinayak, BPH, Hyperplasia of prostate

Published on : Dec 30, 2019 | Views : 4686 | Downloads : 23

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

ppt slide no 1 content not found
Slide 2-

ppt slide no 2 content not found
Slide 3-

ppt slide no 3 content not found
Slide 4-

ppt slide no 4 content not found
Slide 5-

Dr. VINAYAK J. PANCHAL. PG Scholar Dept of Shalya Tantra N. K. J. Ayurvedic Medical College and PG centre MOB NO- 9405160287, E-MAIL- dr.vinayakpanchal@gmail.com BPH (Benign Prostatic Hypertrophy )
Slide 6-

SYNONYMS Senile enlargement of prostate Benign Adenoma of prostate Adenomyoma of prostate Benign prostatic Hyperplasia Nodular Hyperplasia HYPERPLASIA = Owergrowth in number of tissue cells
Slide 7-

Anatomy of Prostate Gland Acessory Gland Glandular tissue in a fibromuscular stroma It surrounds 1st part of urethra Site = lies in lesser pelvis below the neck of urinary bladder, behind the lower part of pubic symphysis and upper part of pubic arch, & in front of ampulla of thr rectum. Size= 3* 4* 2 Wt = normally approx. 18 - 20 gm .
Slide 8-

Anatomy of Prostate Gland Lobes = 5 ( ant, post, 2 lat. 1 median) Capsuls = 1) True capsul= formed by peripheral part, fibromuscular, continues with stroma, no venous plexus 2) False capsule = lies out side the true capsule, derived from endopelvic fascia Blood supply = Inf. Vesical Middle rectal Int. pudendal Atr. Venous return= Int. pudendal Int. Iliac
Slide 9-

Zones of prostate
Slide 10-

ppt slide no 10 content not found
Slide 11-

ppt slide no 11 content not found
Slide 12-

Hormonal changes on prostate (Normal) Hypothalamus LHRH (Leutinising hormone Relesing hor.) Ant. Pitutary Lobe LH (Leutinising Hormone) Leyding cell of testis Testesteron Prostate 80% Prostatic Fluid 20% By 5 Alpha reductase in high conc. 5 dihydrotestesteron ( DHT)= Normal growth of prostate 2% to 5%
Slide 13-

AETIOLOGY 1) IDIOPATHIC 2) AGE RELATED 3) 50 YRS « CAUSES 1) Hormonal Theory 2) Neoplastic Theory Hormonal Theory Androgenic activity Androgen = Oestrogen Predominance of Oestrogen Neoplastic Theory Growth of benign neoplasm i.e. Adenoma / Adenomyoma Fibroadenomyoma
Slide 14-

Mechanisms of enlarge prostate (Hormonal theory) Old age – Oestrogen & Adrogen Ant. Pitutary Lobe LH Total conversion by 5 Alpha reductase Hypothalamus LHRH Testesteron 5 dihydrotestesteron ( DHT) Directly responsible for of Prostate
Slide 15-

PATHOLOGY CHENGES = 2 TYPES OWERGROWTH OF GLANDULAR ELEMENT - Soft OWERGROWTH OF CONNECTIVE TISSUE ELEMENT- Firm Lobes Involved 1) Median – gland Project upword in bld. thru int.spi. 2) Lat. Lobe – gland Project from sides in bld. thru int.spi.
Slide 16-

ppt slide no 16 content not found
Slide 17-

ppt slide no 17 content not found
Slide 18-

DUE TO BPH IN URETER & KIDNEY IN BLADDER IN URETHRA ABNORMAL CHANGES
Slide 19-

Changes in Urethra Elongation of urethra twice to Normal. Posteriorly exuggeration of normal prostatic curve. Lateral compression of urethra .
Slide 20-

Hypertrophy of bld. Wall Hypertrophy of trigone Formation of diverticula Overflow incontinance Post prostatic pouch Residual urine Vesicle piles Changes in the Bladder
Slide 21-

Changes in Ureters & Kidney Hydroureter & Hydronephrosis due to Hypertrophy of trigone downward traction on the intramural segment of ureters obstruction to urine flow
Slide 22-

2) Vesicoureteric reflux. Residual urine Chr. Retention of urine Damage to the spincture of ureteric orifice Incomptance of ureto vesical valve 3) Acute or Chr. Pylonephritis 4) Uraemia
Slide 23-

SYMPTOMS
Slide 24-

ppt slide no 24 content not found
Slide 25-

ppt slide no 25 content not found
Slide 26-

Physical Signs General Examination Renal insufficiency Hypertension Cardiac assessment 2) Nervous Tebes dorsalis Multiple sclerosis Parkinson's disease 3) Peripheral nerve S3 & S4 nerve Exam.
Slide 27-

Local Examination P/A = Fullness of Bladder Loin = Renal enl. Hydronephrosis
Slide 28-

Rectal Examination Precaution : Evacuation of bladder Position : Left lat. Obeservation : prost. enla. – smooth, convex, firm swelling Rectal mucosa – easily sliding prostate Residual Urine may felt as a fluctuating swelling just above & behind the prostate
Slide 29-

Investigations Urine R/M = Pus cell, C/S, Oxalates, RBCs Urine flowmetry = N= 15ml/sec. CBP = Hb%, WBCs, ESR, RFT = Sr.Urea, Sr. Creatinine . PSA = Prostatic Specific Antigen Glucoprotine Function = facilitate liquification of semen Measure by Immunoassay tech. Normal Upper Limit = 4nmol/ml BEP Limit = 4-15 Prostatic Ca = 15 nmol/ml Metastasis = 30 nmol/ml
Slide 30-

X RAY (PLAIN)
Slide 31-

USG / TRANSRECTAL USG USG = Detection of size, wt, post void urine etc. T/r USG = Accurate size, early detection of Ca Useful when PSA high. surface of prostate is hard & irregular.
Slide 32-

IVP Renal Calculi Hydronephrosis Enlarge Bladder Hydroureter Metastasis spine
Slide 33-

Cystourethroscopy Indication To inspect urethra prostate lobe bladder spincter other bladder changes
Slide 34-

ppt slide no 34 content not found
Slide 35-

ppt slide no 35 content not found
Slide 36-

Quality of Life Acute urine retention
Slide 37-

Ex. Tamulosin Dose – 0.4/0.8 mg OD Ex. Dutasteride Dose – 0.5 mg OD
Slide 38-

BPH – Hormonal Therapy GnRH Analogs (Binds Pitutari recp. And LH release) Ex.- Leuprolide Acetate Route – IM /SC Dose – Anti androgens (Inhibits the androgen uptake) Ex- Flutamide Route – oral Dose – 125mg TID
Slide 39-

ppt slide no 39 content not found
Slide 40-

SURGICAL T/t
Slide 41-

INDICATIONS OF SURGERY 1) Acute Retation. 2) Chr. Retation 3) Frequency ( Day & Night) – discomfort 4) Haemorrage 5) Complications – Diverticulum Calculus etc. ( Residual Urine > 200 cc)
Slide 42-

ppt slide no 42 content not found
Slide 43-

PROSTATECTOMY A CC. APPROCH ( 2 ) 1) OPEN – SUPRAPUBIC (Freyer’s) RETROPUBIC (Millin’s) PERINEAL (Young’s ) 2) CLOSE- TRANSURETHRAL ( TURP) ACC. METHOD (2) 1) RADICAL 2) ENUCLEATION
Slide 44-

ppt slide no 44 content not found
Slide 45-

SUPRAPUBIC
Slide 46-

POST OP CARE I V fluides & Glycine irrigation. Antibiotics Analgesics Antiemetics Sedative ( if needed ) Liquid diet for 12 hrs after 8 hrs of O.T. Normal diet after 24 hrs Suprapubic drain remove after 48 hrs ( fluide should be bloodless) 9) Urethral catheter remove after 10 day ( urine should be clear )
Slide 47-

ppt slide no 47 content not found
Slide 48-

POST OP CARE = Same as pervious ADVANTAGE OVER SUPRAPUBIC 1)Bladder opening not needed = no bleeding in bladder Bleeding in retro. Space can remove with simple drain Short recovery period. DISADVANTAGE # Diverticula & stone can be missed
Slide 49-

ppt slide no 49 content not found
Slide 50-

Epididymitis Bladder neck stricture Rectrograde ejaculation & Impotancy Stricture of urethra
Slide 51-

INDICATION Small prostate Obstruction without enlag. of lat. Lobe median lobe enlar. Ca prostate ( Localised)
Slide 52-

1) PUCH TURP
Slide 53-

2) WIRE LOOP DITHERMY
Slide 54-

DIC = Disseminated intravascular coagulopathy
Slide 55-

BEFORE T/t AFTER T/t
Slide 56-

www.slideshare.net by name. Ex. Dr.Panchal v. Agnikarama Suggestions Likes Comments Thank You