136. Prostatitis. Nodular hyperplasia of the prostate.

Question 1

Prostatitis

Answer 1

inflammation of prostate gland
divided into 3:
   - acute bacterial prostatitis
   - chronic bacterial prostatitis
   - chronic pelvic pain syndrome

Question 2

acute bacterial prostatitis

Answer 2

causes: proteus, klebsiella, enterobacter, pseudomonas, e. coli, staph, chylamdia, gonorrhoeae
symptoms: chills, fever, dysuria
features: tender, urine will show WBC and bacteria
complication: sepsis

no digital rectal exam, cause the pressure on the tender prostate can cause bacteremia

Question 3

chronic bacterial prostatitis

Answer 3

cause: recurrent UTIs
symptoms: lower back pain, dysuria
features: urine cultures are negative

Question 4

chronic pelvic pain syndrome

Answer 4

causes: idiopathic, might not be related to prostate at all
symptoms: chronic pain localized to perineum, suprapubic area, and penis; pain during ejaculation is common.
subtypes: could be inflammatory (leukocytes in prostatic secretion) or non-inflammatory

Question 5

Nodular hyperplasia of prostate

Answer 5

definition: hyperplasia, non-cancerous growth of prostate gland

risk groups: older men, over the age of 40

normal function: androgens (T and DHT) stimulate growth of luminal and basal cells of the prostate and prevent apoptosis

pathogenesis: as we grow older, the enzyme that (alpha5-reductase) converts testosterone to dihydrotestorone gets hyperactivated, leading to benign prostate growth.
complication: those cells tend to grow on periurethral zone (central and inner transition zone) and compresses the urethra that pass there leading to obstruction which causes bladder dilation and hypertrophy of its muscle
symptoms: weak stream, dysuria, nocturia, hesitancy

complicationL UTI, hydronephrosis, no risk of prostate cancer

diagnosis: urinary obstruction, elevated PSA levels since there are more cells making PSA