Case Studies in Benign Prostatic Hyperplasia

[MD FACS Urology] - Director, URO Center of New York

Introduction - overview of lower urinary tract symptoms in men; KM:49 y/o - prostatic obstruction treated with alpha blockers; RM:40 y/o - prostatic obstruction and detrusor instability masquerading as "prostatis" in a young man; DM:73 y/o with impaired detrusor contractility due to bladder diverticulum; RB:40 y/o - prostatic obstruction evolving from acontractile bladder and chronic urinary retention treated for years with intermittent catheterization followed by TURP; RD:52 y/o -nocturia caused by prostatic obstruction and nocturnal urine overproduction; AM:55 y/o - prostatic obstruction and detrusor instability Rx with TUNA>amelioration of obstruction, but persistent detrusor instability; SJ:64 y/o - prostatic obstruction, low bladder compliance, hydronephrosis; AF:70 y/o -post-prostatectomy incontinence, mild but bothersome treated conservatively; AK:42 y/o - vesical neck obstruction in a very symptomatic young man treated at first medically, then surgically; RP:74 y/o - severe detrusor instability treated with augmentation cystoplasty; LG:69 y/o - detrusor instability without obstruction; MM:25 y/o - borderline bladder neck obstruction versus impaired detrusor contractility, treated with Tamsulosin; RS:49 y/o - BPH "natural cause"; AB:81 y/o - prostatic obstruction, detrusor instability, vesicoureteral reflux and Parkinson's disease successfully treated with TURP; MP:81 y/o - learned voiding dysfunction and detrusor instability vs. DESD; SS:67 y/o - severe prostatic obstruction and detrusor instability in a patient with localized prostate cancer treated with radical prostatectomy; PV:75 y/o - prostatic obstruction, prostate cancer RX anti-androgens, alpha blockers; PD:56 y/o - prostatic obstruction, detrusor instability unsuccessfully Rx with alpha blockers, Rx suprapubic prostatectomy; SW:72 y/o with postprostatectomy incontinence treated with GU sphincter; AC:45 y/o - bladder neck obstruction, treated with transurethral incision of the bladder neck; GH:68 y/o - diabetes, prostatic obstruction, detrusor instability, treated with transurethral resection of the prostate; FS:59 y/o - prostatic obstruction, detrusor instability, bladder diverticula; AD:69 y/o - radiation induced prostatic urethral obstruction and detrusor instability; FN:68 y/o - prostatic obstruction, detrusor instability, bladder diverticulae, treated with TURP; MS:53 y/o - prostatic bladder neck obstruction which failed alpha blockade and TUNA; JM:52 y/o - large capacity bladder, prostatic obstruction, polyuria; AS:77 y/o - detrusor external sphincter dyssynergia following transurethral resection of the prostate, treated with oxybutynin and self intermittent catheterization; CC:82 y/o - LUTS in an elderly man with detrusor instability treated with anticholinergics, behaviour modification and pelvic floor exercises; JM:63 y/o - prostatic obstruction Rx intermittent catheterization for 14 years, then suprapubic prostatectomy; GM:59 y/o - postprostatectomy incontinence and ana