Benign Prostat Hiperplasia

Written by:
Khansadhia Hasmaradana Mooiindie
Advisor by:
Dr. Febrianto, Sp.B (K) Onk
 PENDAHULUAN
Angka kejadian BPH meningkat seiring bertambahnya usia
(meningkat 43% pada pria berusia di atas 60 tahun)

BPH tidak mengancam jiwa, namun menurunkan kualitas

hidup pasien
ANATOMI
• Tebal 2cm
• Panjang 3cm

• Lebar 4cm

• Berat 20gr

• Bentuk piramid terbalik

• Uretra pars prostatika

 ANATOMI
Zona Ventalis
• StromaFibromuskuler
• 1/3 prostat

Zona Perifer
• 70% massa prostat
• Rentan inflamasi & asal CA prostat

Zona Sentralis
• Antara duktus ejakulatorius
• Resisten terhadap infalamsi
• 25% masa prostat

Zona Transisional
• Bagian terkecil 5%
• Letak dari BPH
ANATOMI
VASKULARISASI
ANATOMI

Parasimpatis (S2-S4) : kontraksi

Simpatis (L1-L2) : sekresi
 DEFINISI

Proses hiperplasi masa nodul fibromyoadenomatous pada inner zone kelenjar

prostat periuretral, sehingga jaringan prostat di sekitarnya terdesak dan
membentuk kapsul palsu di sisi luar jaringan yang mengalami hiperplasi.

Tidak bersifat ganas

BPH ≠ hipertrofi (belum tentu

bertambah besar)
 EPIDEMIOLOGI

• Prevalence meningkat seiring bertambahnya usia

• Usia 40-49 :15%
• Usia 50-59 : 25%
• Usia >60 : 43%
• Penyakit no.2 dalam bagian urologi setelah batu saluran kemih
ETIOLOGI
01 Teori dihidrotestosteron

Ketidakseimbangan estrogen-progeste
02 ron

03 Interaksi stroma-epitel

04 Apoptosis menurun

05 Teori stem cell

 ETIOLOGI
Teori dihidrotestosteron

Kompleks DH
Sintesis GF Reseptor Androgen
T-RA

Pertumbuhan sel
 ETIOLOGI
Ketidakseimbangan estrogen-progesteron

proses hiperplasia (jumlah sel menjadi banyak)

ETIOLOGI
Interaksi Stroma - Epitel
 ETIOLOGI
Apoptosis

Androgen Estrogen TGF-β

Apoptosis menurun
 ETIOLOGI
Teori Stem Cell

Ketidaktepatan aktivitas stem cell

Produksi sel stroma & epitel berlebih

FAKTOR RISIKO

Usia Obesitas

Ras

Family
history
Hormon DM
PATOFISIOLOGI
PATOLOGI ANATOMI
 GEJALA KLINIS

Obstruktif Iritatif

1. Urgency (Non koordinasi antara kontraksi

m.destrusor dg relaksasi m.spinter)
1. Hesitancy (perlu waktu bila ingin miksi ) 2. Frequecy (miksi > 8x/hr)
2. Weak steam (Pancaran lemah)  Karena Pengosongan VU tak sempurna
3. Straining (Kencing mengejan)  Pembesaran prostat ke vu
4. Prolonged micturition (Kencing perlu waktu lama)  Hipertrofi m.destrusor vesicae
5. Incomplete emptying (Kencing tak puas) 1. Nocturia (miksi > 2x semalam)
2. Urge incontinencia (Tidak bisa menahan
kencing)
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