43 / 44 - Urethra / Prostate Flashcards
Name the different portions of the urethra in the male dog
A: Prostatic
B: Membranous
(A+B = intrapelvic portion)
C: Penile (cavernous)
Where is the feline prostate located?
Dorsolaterally
What volume of contrast is advised for retrograde urethrography?
5-20ml
(5-10ml in female dogs)
What volume of contrast is recommended for canine vaginocystourethrography?
1ml/kg
AVOID HIGH PRESSURE, make sure balloon is inflated in vestibule
What are the two most signficant complications of retrograde urethrography?
Urinary tract rupture,
UTI
What are the two most common locations of urinary calculus obstruction in male dogs?
Ischia arch,
Base of os penis
Name 3 normal anatomical variants that may be confused with urethroliths
Feline os penis
Seperate ossification centre of canine Os penis (cranial location makes unlikely to be urethrolith)
Nipple!
Granulomatous urethritis is associated with which signalment?
Female dogs
List three reported causes of urethral masses
TCC (urethral vs extension of bladder)
Prostatic carcinoma
Fibroepithelial polyps
List possible features of urethral stricture expected radiographically (contrast)
Consistently visible narrowing
Irregular urethral surface
Proximal dilation of urethra
What is the normal size and location of the feline prostate?
Dorsolateral, pelvic location
Approx 10mm
What is the pathophysiology of BPH?
Increased volume of intercellular and ductal spaces (NOT intracellular or cell no.)
=> Solid hypertrophy -> cystic hypertrophy (later stage)
Name the 2 most common prostatic diseases
BPH
Prostatitis
Describe features of chronic prostatits
May be SMALL gland (fibrotic), can cause urethral stricture
ACCORDING TO THRALL, how does incidence of prostatic adenocarcinoma compare between intact and neutered male dogs?
Similar incidence!
List 5 features of prostatomegaly on radiography
Displacement of bladder, colon
Narrowing of colon /rectum lumen
Constipation
Presence of ventral fat triangle highlighting vesicoprostatic junction
Size >90% from pubis -> sacral promontory = SUGGESTIVE OF MASS
How large can prostate glands enlarge in BPH? ANnd with cysts / abscesses?
Up to 10x normal
Up to 20x with cysts / abscesses
NB: Acute prostatitis and neoplasia do not usually cause marked enlargement. Chronic prostatitis may make gland small
What may prostatic mineralisation indicate?
Chronic prostatitis or neoplasia
=> wispy or indistinct calcification has strong PPV for neoplasia, partiularly if neutered
What pathological process may result in gas within the prostate?
Gas-forming bacterial prostatitis (coliform or clostridial reported -> severe haemorrhagic / necrotic prostatitis, shock, sepsis)
May result in scarring -> urine retention, loss of sphincter mechanism, sterility
RULE OUT iatrogenic causes. May fill DUCTS during negative contrast studies etc, but not parenchyma.
Where do prostatic neoplasms metastasise to?
MILN
Lumbar vertebrae
Pelvis
GIve three examples of masses that may be confused with the urinary bladder (retrograde can help to clarify)
Paraprostatic cyst,
Omental tumour,
Retained testicular tumour
What two features of the prostatic urethra should be highly suggestive of neoplasia?
Ulceration,
Stricture
Which structures of the prostate MAY normally may fill with contrast?
What features of contrast accumulation are considered abnormal?
Normal:
Ducts!
Or no filling (but can still be abnormal prostate and no filling)
Abnormal:
Pooling of contrast,
Irregular shaped cavities with rough walls communicating with urethra (suggestive of neoplasia),
Cavitary smooth walled lesions containing intraluminal masses (suggestive of neoplasia).
What 4 features may effect the size of the prostatic urethra on retrograde?
Injection pressure,
Size of prostate,
Pathology present,
Bladder distension,
