Module 3.1 (BPH and Prostatitis) Flashcards
Mens health poorer than womens because they are reluctant to access health services, less interested/concerned about their health, less likely to report symptoms, behaviours and attitudes related to career and lifestyle choices, sociocultural and biological factors
true or false
true :(
What is the difference between hypertrophy and hyperplasia for benign prostatic…?
> enlarged prostate
Hyperplasia = increased number of cells
Hypertrophy = increased cell size
What is the most common benign tumour in men?
Benign prostatic hyperplasia
> not cancer
> doest not raise the risk of prostate cancer
What condition is associated with the most lower urinary tract symptoms in those >50 years in men?
Benign prostatic hyperplasia
What causes BPH? Risk factors?
Causes: directly related to ageing and hormonal activity
Risk factors: NONE known (other than testicles functioning normally)
> removing testicles (e.g. due to cancer) results in prostate shrinking
What does enlarged prostate lead to?
Obstructs urethra and bladder = LUTS associated with BPH
> 50% of males aged 51-60 years
> 90% of those over 85 years old
Pathophysiology of BPH?
Prostate divided into an inner and outer zone
> inner zone = BPH
> outer zone = Malignancies
- Testosterone converted by 5-alpha reductase to dihydrotestosterone (DHT)
- DHT stimulates hormone growth factors –> influence cell division/proliferation –> prostate enlargement and hyperplasia
> more cell proliferationa and less cell death
What are some signs and symptoms of BPH? Why do this these things occur?
Prostate enlargement compresses urehtra which in addition to increase adrenergic tone causes outlet obstruction
> benign clinical enlargement (BCE)
> bladder outlet obstruction (BOO)
> lower urinary tract symptoms (LUTS)
> failure to store urine (irritative symptoms)
- frequency
- nocturia = get up at night to shishi
- urge incontinence and urgency = sudden urge to urina
> failure to empty the bladder (obstructive symptoms)
- hesitancy to initiate urination
- poor flow
- dribbling after urination
- incomplete emptying sensation
What laboratory findings and investigations to do for BPH?
U & Es, FBC, LFTs
> ALP elevations: prostate malignancy
Prostate Specific Antigen (PSA)
> rules out cancer, levels raised in BPH
Digital Rectal Examination (DRE)
> general idea about the size and condition of the prostate
Transrectal ultrasound (TRUS)
Urinalysis
> rules out infection
What are complicatiosns with BPH?
Acute urinary retention (emergency treatment required)
Renal impairment
Haematuria due to bladder obstruction (blood in urine, rupture of veins in urethra)
Recurrent UTI
Severity of symptoms not related to prostate size
What is prostatitis? 3 main types?
Inflammation of the prostate gland
Affects men at any age
Major effect on quality of life
3 main types
> acute bacterial
> chronic bacterial
> chronic non-bacterial
Explain acute bacterial prostatitis
- Associated with acute UTI, trauma, bladder outflow obstruction
- Can progress to chronic
- Least common form of prostatitis
- Serious
Explain chronic bacterial prostatitis
- Chronic/relapsing UTI
- Associated with pain/discomfort
- Rare
Explain chronic non-bacterial prostatitis
AKA chronic pelvin pain syndrome = pelvic pain, LUTS
> pain affects lower abdomen; lower back, rectu, penis, testicles, perineum
> not associated with UTI
> 90-95% of cases of chronic prostatitis
Signs and symptoms of prostatitis?
- LUTS
- Perineal pain, prostatic tenderness and fever (acute prostatitis)
- Chronic pelvin pain (chronic prostatitis)
- Chronic prostatitis symptom index (CPSI)
> used to define severity; also for monitoring
