9. Disorders Of The Prostate

Question 1

What are some disorders of the prostate?

Answer 1

Prostatitis

Benign prostatic hypertrophy

Question 2

What are the main pathogens of acute prostatitis?

Answer 2

E.coli
Proteus and staphylococcus species
STIs - C.trachomatis, N.gonorrhoeae

Question 3

How do patients with acute prostatitis present?

Answer 3

General symptoms - malaise, rigours, fever

Local symptoms - difficulty in passing urine, dysuria, perineal tenderness

Question 4

What does a rectal examination show in acute prostatitis?

Answer 4

Soft, tender and enlarged prostate

Question 5

What are common cause of acute prostatitis?

Answer 5

UTI

Catheterisation

Question 6

Why does chronic prostatitis occur?

Answer 6

Results from inadequately treated infection

Can occur because some antibodies cannot penetrate prostate effectively

Question 7

How is chronic prostatitis diagnosed?

Answer 7

Histological examination showing neutrophils, plasma cells and lymphocytes
Positive culture sample of prostatic secretion

Question 8

What is the most common type of prostatitis?

Answer 8

Chronic non-bacterial prostatitis - enlargement of prostate

Question 9

What is the usual pathogen of chronic non-bacterial prostatitis?

Answer 9

C.trachomatis so typically sexually ascites men are affected

Question 10

What does histological examination show in chronic non-bacterial prostatitis?

Answer 10

Fibrosis as a result of chronic inflammation

Question 11

What is benign prostatic hypertrophy?

Answer 11

Detectable in nearly all men over 60
Non-neoplastic enlargement of prostate gland, can lead to bladder outflow obstruction
Cause is unknown but may be related to levels of testosterone

Question 12

What do men with BPH present with?

Answer 12

Difficulty or hesitancy in starting to urinate
A poor stream
Dribbling postmicturation
Frequency and nocturia

Question 13

What does a DRE sho in BPH?

Answer 13

Form, smooth and rubbery

Question 14

What can untreated BPH cause?

Answer 14

Acute urinary retention
Accompanied by a distended and tender bladder and a desperate urge to pass urine
Progressive bladder distension, chronic painless retention and overflow incontinence
Can lead to bilateral upper tract obstruction and renal impairment, CKD

Question 15

What is the treatment for BPH?

Answer 15

Alpha blockers - read smooth muscle at bladder neck and within prostate
Finasteride- presents conversion of testosterone to more potent androgen dihydrotestosterone
Surgical - transurethral resection of prostate