diseases of the prostate gland

Question 1

common diseases of the prostate gland

Answer 1

benign enlargement
carcinoma
prostatitis

Question 2

what is psa

Answer 2

a glycoprotein that is expressed by normal and neoplastic prostate tissue and secreted into the bloodstream
concentrations can be increased by any condition affecting the prostate

Question 3

benign prostatic hyperplasia - what is it / who does it affect?

Answer 3

hyperplasia of both the glandular and connective tissue elements of the gland
common after 60y

Question 4

clinical features BPH

Answer 4

frequency of micturition, nocturia, delay in initiation of micturition & post void dribbling
enlarged smooth prostate may be felt on examination

Question 5

investigations BPH

Answer 5

serum electrolytes & renal USS performed to exclude renal damage resulting from obstruction
prostate cancer = similar symptoms.
Serum PSA may be elevated - if so refer to specialist for biopsy

Question 6

management BPH

Answer 6

pts w mild symptoms are managed by watchfil waiting
selective a1-adrenoreceptor antagonists eg tamsulosin, relax smooth muscle in the bladder neck & prostate = inc in urinary flow
next step = catheterisation, then prostatectomy

Question 7

what does finasteride do?

Answer 7

It’s a 5a-reductase inhibitor and blocks conversion of testosterone to dihydrotestosterone (the androgen responsible for growth)
alternative to a-antagonists particularly in men with a particularly enlarged prostate