Male Urogenital pathology Flashcards
Benign Prostatic Hyperplasia
- Increased number of both stromal and glandular cells in the prostate
- Enlarged prostate
Epidemiology of BPH
- Old men (70% by aged 60)
- Obesity, diabetes
Aetiology of BPH
- Hormone mediated
- Dihydrotestosterone (DHT)
Pathogenesis of BPH
- Compression of the urethra obstruction of bladder outlet…
- Urinary stasis = infection and stones
- Acute urinary retention
Back pressure = renal damage - Bladder muscular hypertrophy (need to strain)
Clinical features of BPH
- Lower urinary tract symptoms - poor stream, straining, nocturia, dribbling
Prostatic Adenocarcinoma
- Cancer of the glandular epithelium in the prostate
Epidemiology of Prostatic Adenocarcinoma
- Old men, black men
- Family history
- Pesticide exposure
Aetiology of Prostatic Adenocarcinoma
- Obesity, pesticides
- Inherited genetic mutations = BRCA 1/2
Clinical features of Prostatic Adenocarcinoma
- Lower Urinary tract symptoms
- Bone mets = bone pain
Cryptorchidism
- Undescended testis - not in scrotum
Epidemiology of Cryptorchidism
- Premature babies
Aetiology of Cryptorchidism
- Multifactorial - different syndromes and environmental factors
Clinical features of Cryptorchidism
- Empty scrotum (10% bilateral)
- May resolve spontaneously
- Can cause Infertility, hernias, testicular cancer risk and testicular torsion
Seminoma
- Malignant neoplasm of the testis - arising from germ cells in the seminiferous tubules
- Most common type of testicular cancer
Classification of Testicular cancers
- Germ or non germ cell
- Germ = seminoma or non-seminomatous
- Non germ = sex cord stromal tumours or Lymphoma
Prognosis of Testicular cancers
Bad prognosis = non-seminomatous + lymphomas
Good prognosis = Seminoma + Sex cord stromal
Epidemiology of seminoma
- Young men 25-45
- Cryptorchidism
Aetiology of Seminoma
- Gene mutations = KIT
- Cryptorchidism
Clinical features of Seminoma
- Testicular lump, swelling, pain
- Gynecomastia (enlarged breast tissue)
Obstructive lesion presentation
- Complete ob = Anuria (kidneys cannot produce urine), pain