Male Urogenital pathology

Question 1

Benign Prostatic Hyperplasia

Answer 1

• Increased number of both stromal and glandular cells in the prostate
• Enlarged prostate

Question 2

Epidemiology of BPH

Answer 2

• Old men (70% by aged 60)

- Obesity, diabetes

Question 3

Aetiology of BPH

Answer 3

• Hormone mediated

- Dihydrotestosterone (DHT)

Question 4

Pathogenesis of BPH

Answer 4

• 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)

Question 5

Clinical features of BPH

Answer 5

• Lower urinary tract symptoms - poor stream, straining, nocturia, dribbling

Question 6

Prostatic Adenocarcinoma

Answer 6

• Cancer of the glandular epithelium in the prostate

Question 7

Epidemiology of Prostatic Adenocarcinoma

Answer 7

• Old men, black men
• Family history
• Pesticide exposure

Question 8

Aetiology of Prostatic Adenocarcinoma

Answer 8

• Obesity, pesticides

- Inherited genetic mutations = BRCA 1/2

Question 9

Clinical features of Prostatic Adenocarcinoma

Answer 9

• Lower Urinary tract symptoms

- Bone mets = bone pain

Question 10

Cryptorchidism

Answer 10

• Undescended testis - not in scrotum

Question 11

Epidemiology of Cryptorchidism

Answer 11

• Premature babies

Question 12

Aetiology of Cryptorchidism

Answer 12

• Multifactorial - different syndromes and environmental factors

Question 13

Clinical features of Cryptorchidism

Answer 13

• Empty scrotum (10% bilateral)
• May resolve spontaneously
• Can cause Infertility, hernias, testicular cancer risk and testicular torsion

Question 14

Seminoma

Answer 14

• Malignant neoplasm of the testis - arising from germ cells in the seminiferous tubules
• Most common type of testicular cancer

Question 15

Classification of Testicular cancers

Answer 15

• Germ or non germ cell
• Germ = seminoma or non-seminomatous
• Non germ = sex cord stromal tumours or Lymphoma

Question 16

Prognosis of Testicular cancers

Answer 16

Bad prognosis = non-seminomatous + lymphomas

Good prognosis = Seminoma + Sex cord stromal

Question 17

Epidemiology of seminoma

Answer 17

• Young men 25-45

- Cryptorchidism

Question 18

Aetiology of Seminoma

Answer 18

• Gene mutations = KIT

- Cryptorchidism

Question 19

Clinical features of Seminoma

Answer 19

• Testicular lump, swelling, pain

- Gynecomastia (enlarged breast tissue)

Question 20

Obstructive lesion presentation

Answer 20

• Complete ob = Anuria (kidneys cannot produce urine), pain