Testicular and Prostate Pathology Flashcards
What is the most common congenital male reproductive abnormality?
Cryptorchidism (~1% of male infants)
What can commonly cause orchitis?
- Chlamydia trachomatis (D-K) or Neisseria gonorrhoea
- E coli, Pseudomonas (UTI associated - older)
- Mumps virus (kids > 10 years)
- Autoimmune orchitis (granulomas involving seminiferous tubules)
- TB (necrotizing granulomas)
What is Prehn sign and what does it prove?
- Pain relief with scrotal elevation
- Prehn +ve = epididymitis
What kind of infarction is in testicular torsion?
Hemorrhagic infarction
What congenital failure may cause testicular torsion?
Congenital failure of testes to attach to inner lining of scrotum
What pathology is varicocele associated with?
Left-sided renal cell carcinoma
What does varicocele present with?
Scrotal swelling with bag of worms appearance
What is hydrocele?
Fluid collection within tunica vaginalis
What is hydrocele caused by in infants?
Congenital hydrocele is caused by an incomplete obliteration of processus vaginalis
What is hydrocele caused by in adults?
Secondary to infection, trauma, tumor
- Blockage of lymphatic drainage
What does hydrocele present as?
Scrotal swelling that can be transluminated
What can varicocele be treated with?
- Surgical ligation or embolization
How is testicular torsion treated?
- Surgical correction (orchiopexy) within 6 hrs
- Manual detorsion if surgical option unavailable in timeframe
When does orchiopexy need to be performed (time-frame)?
Within 6 hours
What maneuver may diagnose varicocele =?
Valsalva (blowing whilst obstructing mouth and nose)
What is spermatocele?
Cyst due to dilated epidydimal duct or rete testis
What is acute prostatitis due to?
Acute inflammation of the prostate usually due to bacteria
- N gonnorhoea or C trachomatis
What does acute prostatitis present with and what does it show on examination?
- Dysuria
- Fever and chills
- Tender and boggy on DRE
What does prostatitis secretions show?
- WBCs
- Cultures show bacteria in acute, cultures are negative in chronic
What does chronic prostatitis present with?
- Dysuria
- Pelvic or low back pain
What is bph?
- Hyperplasia of prostatic stroma and glands
Is there an increased risk of prostate cancer with bph?
No
What areas does BPH affect?
- Periurethral zone of prostate
- Lateral lobes, anterior lobe, middle lobe (NOT posterior lobe)
What lobe is affected by prostate cancer?
Posterior lobe (peripheral zone)
What can chronic prostatitis be due to?
- Bacterial Non -bacterial - Secondary to previous infection - Nerve problems - Chemical irritation
What are the treatment options for BPH?
- Finasteride (5-a reductase inhibitor)
- Tamsulosin, terzosin (a1 antagonist)
- Tadalafil (PDE-5 inhibitors)
- Surgical resection (TURP, ablation)
How is prostatic adenocarcinoma graded?
Gleason grade
- Based on glandular architecture - correlates w. metastatic potential
What are signs/symptoms of prostatic adenocarcinoma metastasis?
- Lower back pain
- Increased serum ALP and PSA
What does metastasis to the spine occur via?
Batson (vertebral) venous plexus
What are useful tumor markers for prostatic adenocarcinoma?
- PAP - prostatic acid phosphatase
- PSA - prostate specific antigen
What kind of biopsy for prostate?
needle core biopsies
- Transrectal
