prostate Flashcards
4 zones of prostate?
anterior fibrouscular
central - surrounds ejaculatory ducts
transitional (zone that grows in BPH)
peripheral - zone that cancer develops in
which zone does cancer develop in ?
peripheral zone - this is why it can present late
what is the anatomical landmark of the prostatic urethra?
verumontanum
what does the prostate secrete?
alkaline fluid that contributes to semen
what do the seminal vesicles produce?
glucose and protein rich secretions
3Ps of prostate cancer?
primary carcinoma
peripheral zone
in posterior lobe
voiding symptoms ? BPH
WISE weak flow intermittent flow straining incomplete emptying
storage symptoms in BPH?
FUN
frequency
urgency
nocturia
site in which the ejaculatory and prostatic ducts drain into the urethra?
verunontanum
BPH, very common, occurs in majority of men over the age of?
50
where does the proliferation usually occur in BPH?
transitional zone
which zone surrounds the prostatic urethra?
transitional zone
why do you get incontinence in BPH?
due to failure to empty the bladder with voiding
how do you assess the severity of BPH?
number of times up per night impact of nocturne on sleep presence of incontinence (pads/having to change underwear) ability to continue with ADL
what does prostate feel like in BPH?
smoothly enlarged
investigations for BPH?
urinalysis
toilet diary
uroflowometry (assess flow of urine)
bladder scan
how do you rule out prostate cancer
PSA +- biopsy
self help management for BPH
bladder training
lifestyle changes - reduce caffeine/alcohol, limit amount of fluid in the evening
medical management of BPH
- alpha blockers (tamsulosin)
2. 5ar inhibitors (finasteride)
side effects of alpha blockers and finasteride
- alpha blockers - dry mouth, erectile dysfunction, erectile dysfunction
- finasteride - reduced libido, erectile dysfunction
surgical options for BPH?
trans urethral prostatectomy
transurethral incision of the prostate
Trans urethral laser induced prostatectomy
o Retro pubic prostatectomy used for very large glands.
complications of surgery for BPH?
incontience, clot retention, erectile dysfuction, urethral stricture (LUTS), temporary haematuria and haematospermia,
what is TURP syndrome?
Rare complication that develops due to systemic absorption of the irrirgation fluid used in TURP
how does TURP syndrome present?
o Hypothermia.
o N/V, confusion, visual disturbance, convulsions and coma.
o Bradycardia, alterations in BP, hypoxia and pulmonary oedema.
management of TURP syndrome?
supportive care
