Medical Therapy
(A) Alpha-1 Adrenergic Blockers
First-line therapy for moderate to severe LUTS
Examples:
• Tamsulosin
• Alfuzosin
Mechanism: Relax smooth muscle in bladder neck and prostate → improve urine flow.
Adverse effects: Postural hypotension, dizziness, retrograde ejaculation.
(A) Alpha-1 Adrenergic Blockers
First-line therapy for moderate to severe LUTS
Examples:
• Tamsulosin
• Alfuzosin
Mechanism: Relax smooth muscle in bladder neck and prostate → improve urine flow.
Adverse effects: Postural hypotension, dizziness, retrograde ejaculation.
5-Alpha Reductase Inhibitors
Used when prostate is enlarged (>40 mL)
Examples:
• Finasteride
• Dutasteride
Mechanism: Block conversion of testosterone → DHT → reduces prostate volume.
Effect: Takes 3–6 months to work.
Adverse effects: Decreased libido, erectile dysfunction.
Used when prostate is enlarged (>40 mL)
Examples:
• Finasteride
• Dutasteride
Mechanism: Block conversion of testosterone → DHT → reduces prostate volume.
Effect: Takes 3–6 months to work.
Adverse effects: Decreased libido, erectile dysfunction.
Combination Therapy
Alpha-blocker + 5-alpha reductase inhibitor
• For patients with large prostates and severe symptoms.
Alpha-blocker + 5-alpha reductase inhibitor
• For patients with large prostates and severe symptoms.
Phosphodiesterase-5 Inhibitors
Example: Tadalafil
• Improves LUTS and erectile dysfunction simultaneously.
• Sometimes combined with alpha-blocker.
Example: Tadalafil
• Improves LUTS and erectile dysfunction simultaneously.
• Sometimes combined with alpha-blocker.
Surgical & Minimally Invasive Options
TURP (Transurethral Resection of Prostate)
Gold standard for prostates <80 g. Removes obstructing tissue.
Open Prostatectomy
For very large glands (>80–100 g)
Catheterization (temporary)
For acute urinary retention or poor surgical candidates.
TURP (Transurethral Resection of Prostate)
Gold standard for prostates <80 g. Removes obstructing tissue.
Open Prostatectomy
For very large glands (>80–100 g)
Catheterization (temporary)
For acute urinary retention or poor surgical candidates.
UroLift
Small–medium prostate, no large median lobe
Preserves ejaculation and erection
Rezum (steam ablation)
Small–medium prostate, mild median lobe
Durable results, minimal sexual side effects
TUNA / TUMT (heat or microwave)
Patients unfit for surgery or anesthesia
Small–medium prostate, no large median lobe
Preserves ejaculation and erection
Rezum (steam ablation)
Small–medium prostate, mild median lobe
Durable results, minimal sexual side effects
TUNA / TUMT (heat or microwave)
Patients unfit for surgery or anesthesia
Lab Rats In Lab Coats
Post-cholecystectomy syndrome (PCS)
persistence or recurrence of biliary or gastrointestinal symptoms after removal of the gallbladder (cholecystectomy).
These symptoms can appear immediately after surgery or months to years later.
These symptoms can appear immediately after surgery or months to years later.
Lab Rats In Lab Coats
persistence or recurrence of biliary or gastrointestinal symptoms after removal of the gallbladder (cholecystectomy). These symptoms can appear immediately after surgery or months to years later.
Most common cause Retained common bile duct (CBD) stone
Stone left behind during surgery or newly formed after surgery.
Stone left behind during surgery or newly formed after surgery.
Thats may lead Ascending cholangitis is a bacterial infection of the biliary tree (bile ducts), usually caused by bile duct obstruction that allows bacteria to ascend from the duodenum into the biliary system.
It’s a life-threatening emergency that requires urgent management.
It’s a life-threatening emergency that requires urgent management.
ملاحظه ممكن يصير
Ascending cholangitis
بدون منشيل gallbladder وهنا ممكن شي اليفدنا حتى نفرق هو Destination of
gallbladder
Ascending cholangitis
بدون منشيل gallbladder وهنا ممكن شي اليفدنا حتى نفرق هو Destination of
gallbladder
Courvoisier’s Law
“In a patient with obstructive jaundice and a palpable, non-tender gallbladder, the cause is unlikely to be gallstones.”
It means:
If the gallbladder is enlarged and not painful, the obstruction is probably due to a malignant process — not gallstones.
سو لازم افكر ca حتى يثبت العكس
“In a patient with obstructive jaundice and a palpable, non-tender gallbladder, the cause is unlikely to be gallstones.”
It means:
If the gallbladder is enlarged and not painful, the obstruction is probably due to a malignant process — not gallstones.
سو لازم افكر ca حتى يثبت العكس
Lab Rats In Lab Coats
Photo
gallstone ileus, a specific form of mechanical small bowel obstruction caused by a gallstone that enters the intestinal tract through a biliary-enteric fistula (most often a cholecystoduodenal fistula).