Renal - Prostate

Question 1

Describe the different prostate diseases.

Answer 1

Prostatitis - inflammation of the prostate
Benign prostatic hypertrophy
Prostatic cancer - adenocarcinoma

Question 2

What are the symptoms of urinary tract obstruction?

Answer 2

Slow stream, hesitancy, frequency, urgency, nocturia, incomplete voiding

Question 3

What are the treatment options for benign prostatic hypertrophy?

Answer 3

Initially drug based (a-blocking drugs)

Surgery - prostatectomy (TURP - transurethral prostatectomy, open prostatectomy)

Question 4

What investigations can be used for prostatic malignancies?

Answer 4

PSA (prostatic specific antigen) blood test

Only useful for monitoring disease activity as it has problems with sensitivity and specificity

Question 5

What are the treatment options for prostatic malignancies?

Answer 5

Surgery (radical prostatectomy)
Radiotherapy
Hormone treatment (anti-androgens)

Question 6

What are the different cause of urinary tract obstruction?

Answer 6

Renal calculi
Prostatic disease - hypertrophy, prostatic malignancy
Urinary tract strictures
External compression - pregnancy, tumour

Question 7

What is the dental relevance of chronic renal failure?

Answer 7

Growth may be slow in children -> tooth eruption may be delayed
Secondary effects of anaemia - oral ulceration, dyaesthesias (painful mucosa and tongue)
White patches - uraemic stomatitis

Question 8

What is the dental relevance of renal disease?

Answer 8

Take care with drug prescribing - check all drugs with renal physician, avoid NSAIDs, some tetracyclines, reduce dose of most others
Oral opportunistic infections (fungal/viral infections, prone to post op infections)
Dry mouth and taste disturbance (fluid restriction and electrolyte disturbance)
Bleeding tendencies (platelet dysfunction)
Renal osteodystrophy - lamina dura lost, bony radioluciences, secondary hyperparathyroidism increases osteoclasts activity