113.Prostate Flashcards
T/Fthe prostate is the sole accessory sex organ of male dogs
TRUEprostate encircles the urethra in dogs (only partly in cats)bilobedfibromuscular capsule
prostatic size and position
size is androgen driveninvolution occurs after castrationabdominal until 2 months of age where it sits in the pelvisat puberty, enlarges and sits partially in abdomencan migrate further cranially with hyper plastic enlargementhalf the gland abdominal by 4 years of agedorsal–rectumlateral–levator ani musclesventral–pubic symphysis and ab wall
blood supply of prostate
prostatic arteries (branch from internal pudendal artery)branch to supply ductus deferens, caudal vesicular artery, and caudal rectalprostatic arteries divide cranial, middle, caudal before perforating capsule and becoming sub capsular arteries supplying glandular tissue
vascular zones of the prostate
- capsular2. parenchymal3. urethral
time of first secretory function of the prostate
4 monthsperiodic acid schiff positive stain for secretory function evidentsecretion increases with agesecretion is androgen mediatedprostatic secretion is considered the THIRD fraction of ejaculate
constituents of prostatic fluid
considerably more acidic than men (6.1-6.5) which is supposed to be more alkaline than female repro tract–hi Zn (antibacT?)–hi proteins (acid phosphatase, canine prostate specific esterase)–electrolytes hi K, Cl similar Na to plasma
function of prostate in testosterone regulation
circulating T is metabolized by 5alpha reductasetestosterone—–>5alpha dihydrotestosterone5 HT binds receptors to control prostatic growthas prostate size increases, tissue 5HT decreases BUT tissue androgen receptors increase and the prostate becomes more responsive to androgens as it ages
diagnostic testing approach to prostatic disease
- Hx and PE (ortho and neuro)2. digital rectal exam3. MDB, UA, Brucella titer4. ejaculate, prostatic transurethral wash, FNA—culture, cytology5. ab rads +/- postive/negative retrograde cystourethrograms6. ab US** 7. Biopsy—core biopsy, incisional(8. Advanced imaging (CT/MRI)9. scintigraphy)
asymmetry of prostate gland of digital rectal may give what differentiasl
- abscess2. cysts3. neoplastic disease4. granulomatous disease
prostatic changes seen on abdominal radiographs
size, shape, positiondisplacement of colon or bladderemphysematous changes (prostatitis)mineralization (castrated–neoplasia)+/- retrograde contrast to determine communication with bladder/urethracompression of colorectal areaLN enlargement
prostatic changes seen on ab US
size, position, margination, symmetry, echo density, cavitation, homogeneity +/- needle aspirate or core biopsy (prostate, LN)+/- therapeutic drainage of cysts/abscess potentially with replacement of fluid with Ab or alcohol
benign prostatic hyperplasia
glandular (young) and complex (older) formspresence of prostatomegaly is not necessarily indicative of dzpain free, homogenous, symmetricaldyschezia**confirm with cytologysurgical tx: CASTRATION
medical treatment of BPH
sx tx: CASTRATION #1medical tx: goal to decr T production or decr conversion to 5alpha HT–antiandrogens–LH inhibitors–LH releasing hormone inhibitors–5 alpha reductase inhibitor
most common route of infection to prostate
ascending from urethraE.coli, Staph, Strep, Proteus, KlebsiellaMycotic infections can also be seen (ascending or hematogenous)
normal defense mechanisms of urogenital tract
–exfoliating urethral cells (shed uropathogens)–mucus secretions (trap uropathogens)–intermittent wash out with urine–local production of cytokines, Ig, and defensins–mobilization of WBC