prostate

Question 1

4 zones of prostate?

Answer 1

anterior fibrouscular
central - surrounds ejaculatory ducts
transitional (zone that grows in BPH)
peripheral - zone that cancer develops in

Question 2

which zone does cancer develop in ?

Answer 2

peripheral zone - this is why it can present late

Question 3

what is the anatomical landmark of the prostatic urethra?

Answer 3

verumontanum

Question 4

what does the prostate secrete?

Answer 4

alkaline fluid that contributes to semen

Question 5

what do the seminal vesicles produce?

Answer 5

glucose and protein rich secretions

Question 6

3Ps of prostate cancer?

Answer 6

primary carcinoma
peripheral zone
in posterior lobe

Question 7

voiding symptoms ? BPH

Answer 7

WISE 
weak flow 
intermittent flow 
straining 
incomplete emptying

Question 8

storage symptoms in BPH?

Answer 8

FUN
frequency
urgency
nocturia

Question 9

site in which the ejaculatory and prostatic ducts drain into the urethra?

Answer 9

verunontanum

Question 10

BPH, very common, occurs in majority of men over the age of?

Answer 10

50

Question 11

where does the proliferation usually occur in BPH?

Answer 11

transitional zone

Question 12

which zone surrounds the prostatic urethra?

Answer 12

transitional zone

Question 13

why do you get incontinence in BPH?

Answer 13

due to failure to empty the bladder with voiding

Question 14

how do you assess the severity of BPH?

Answer 14

number of times up per night 
impact of nocturne on sleep 
presence of incontinence 
(pads/having to change underwear) 
ability to continue with ADL

Question 15

what does prostate feel like in BPH?

Answer 15

smoothly enlarged

Question 16

investigations for BPH?

Answer 16

urinalysis
toilet diary
uroflowometry (assess flow of urine)
bladder scan

Question 17

how do you rule out prostate cancer

Answer 17

PSA +- biopsy

Question 18

self help management for BPH

Answer 18

bladder training

lifestyle changes - reduce caffeine/alcohol, limit amount of fluid in the evening

Question 19

medical management of BPH

Answer 19

1. alpha blockers (tamsulosin)

2. 5ar inhibitors (finasteride)

Question 20

side effects of alpha blockers and finasteride

Answer 20

1. alpha blockers - dry mouth, erectile dysfunction, erectile dysfunction
2. finasteride - reduced libido, erectile dysfunction

Question 21

surgical options for BPH?

Answer 21

trans urethral prostatectomy
transurethral incision of the prostate
Trans urethral laser induced prostatectomy
o Retro pubic prostatectomy used for very large glands.

Question 22

complications of surgery for BPH?

Answer 22

incontience, clot retention, erectile dysfuction, urethral stricture (LUTS), temporary haematuria and haematospermia,

Question 23

what is TURP syndrome?

Answer 23

Rare complication that develops due to systemic absorption of the irrirgation fluid used in TURP

Question 24

how does TURP syndrome present?

Answer 24

o Hypothermia.
o N/V, confusion, visual disturbance, convulsions and coma.
o Bradycardia, alterations in BP, hypoxia and pulmonary oedema.

Question 25

management of TURP syndrome?

Answer 25

supportive care