(Should be in PJ1310) BPH and Erectile Dysfunction Flashcards
some differences between BPH and ED
BPH;
does not affect sexual function
it’s symptoms are linked to urination
main issue is a constricted urethra
while for ED;
it affects sexual function
symptoms are linked to sexual arousal
main issue is the inability to get and maintain an erection
describe the prostate gland(in terms of appearance, size..etc)
a walnut shaped gland that sits below the bladder
Weighs ~20g
Wraps around the urethra
It is composed of both
muscular tissues (30%) and
glandular tissue (70%)
function of the prostate gland
an exocrine gland that stores and secretes slightly alkaline solutions that nourish and protect the sperm
the smooth muscle of the prostate gland contracts to help propel semen into the urethra and out of the body during ejaculation
it produces 25% of the volume of semen
rest of semen produced by seminal vesicles
some of the components of the solution produced or secreted by the prostate gland
Proteolytic enzymes
Prostatic acid phosphorylase
Prostate specific antigen
Citric acid
what regulates the secretions of the prostate gland
hormones, mainly testosterone levels
describe BPH
it is a non cancerous increase in prostate size, due to an increase in prostate cell numbers (hyperplasia)
note it is a hyperplasia, not a hypertrophy(increase in cell size)
not always symptomatic initially, so it diagnosis might be prolonged
only affects males, and is more prevalent with increase in age
some symptoms of BPH
compression of the urethra, leading to urinary flow inhibition, which leads to BOO(bladder outlet obstruction)
Dribbling or incontinence- caused by an overfull bladder
Dysuria- pain while urinating
Hesitancy- difficulty in initiating micturition
Poor stream/weak urine flow
An ‘overactive bladder
if symptoms of BPH left untreated, what happens
it can cause recurrent urinary tract infections, bladder
stones, and retention.
can also cause more serious complications like renal failure or CKD
causes of BPH
main cause unclear
but
Hormonal involvement thought to be a cause of BPH
which class of hormones are thought too be involved in the development of BPH
name the hormones that fall under this class of hormones
androgens. they play a permissive role in BPH development. This means they do not directly cause it but they are necessary for it to occur
testosterone and dihydrotestosterone (DHT)
androgens are the group of sex hormones that give men their ‘male’ characteristics (collectively called virilisation). The major sex hormone in men is testosterone, which is produced mainly in the testes.
testosterone release is split between?
the testis (95%) and the adrenal gland (5%)
name of enzyme that converts testosterone to DHT
5a-Reductase enzyme
both androgens but DHT more potent as it binds more strongly to the androgen receptors
testosterone and DHT (androgens) bind to what? and what does this lead to
androgen receptors and leads to cell growth in sex organs, bones, muscles…etc
the cell growth causes BPH
DHT levels elevated in BPH, even though serum testosterone levels may sometimes be low
state some androgen functions
They are essential for spermatogenesis, the production and maturation of sperm in the testes.
Androgens also promote muscle growth by increasing protein synthesis and help maintain bone density, supporting bone growth during puberty.
They influence libido and sexual behavior
stimulate red blood cell production in the bone marrow, and impact fat distribution and metabolism.
play a role in mood, cognitive function, and overall well-being.
the primary androgen that stimulates growth of
benign and malignant prostate tissue
DHT
oestrogen is aka? is it present in males
oestradiol and yes it is
levels in males increase with age, leading to an increase in androgen receptors(AR)
note DHT ad testosterone main hormones in increasing AR expression
name some tests for BPH and what their collective purpose is
Digital rectal exam
Prostate-specific antigen (PSA)
Uroflow test/cystoscopy
Biopsy
they are carried out to rule out BPH, instead of “rule in” or confirming it’s presence
note that a physical examination of the prostate can also be done by palpating the prostate
what happens when palpating the prostate, and how do we tell if the person has BPH through
a doctor or nurse feels the prostate through the rectum to check for prostate problems or cancer
if positive for BPH, the prostate will feel enlarged, and smooth
note if malignant or prostate is cancerous, the prostate will feel enlarged, hard and lumpy
what is the prostate specific antigen (PSA) test
a protein produced by the prostate gland that can be measured in the blood to help diagnose prostate problems
helps determine PSA density
note that this is a test to rule out BPH BUT PSA levels do increase with BPH
note that it can be used to estimate prostate size
some limitations of the PSA test
lots of false positives
there can be false negatives as well
cannot have sex or ejaculate an hour before the test, else results may be affected
sex, ejaculation and exercise can increase PSA levels
