Urinary track diseases II Flashcards

1
Q

Prostate

A

A gland that surrounds the bladder neck and proximal urethra;

slowly grows with age

Four zones (central, peripheral, transitional, periurethral)

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2
Q

What ages are prostate diseases very common?

A

> age 50

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3
Q

What are three common prostate disease?

A
  • Benign prostatic hyperplasia
  • Prostate cancer
  • Prostatitis - an infection, usually caused by bacteria
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4
Q

What is nodular hyperplasia referred to as?

A

benign prostatic hyperplasia (BPH)

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5
Q

Nodular Hyperplasia

A

non-neoplastic enlargement

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6
Q

Nodular Hyperplasia - Histology

A

fibromuscular and glandular hyperplasia

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7
Q

What happens to the prostate with Nodular Hyperplasia?

A

prostate enlarged with nodule formation

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8
Q

Nodular Hyperplasia - Is it common?

A

common > 60 years

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9
Q

Nodular Hyperplasia - What percentage show symptoms?

A

only 10%

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10
Q

BPH Pathogenesis

A

The cause is unknown, but might be related to levels of male sex hormone (testosterone)

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11
Q

BPH Pathology

A

Nodular hyperplasia

− Stroma (smooth muscle and fibrous tissue)

− Glands

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12
Q

BPH Pathology Flow Diagram

A

Hyperplasia
(lateral and median lobe)

compression of urethra

bladder outflow obstruction

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13
Q

BPH Main Symptoms

A

Hesitancy in Initiation of Micturition

A poor stream

dribbling postmicturition

frequency and nocturia

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14
Q

BPH- Investigation

A

Digital rectal examination for the prostate (firm, smooth & rubbery)

Abdominal examination for an enlarged palpable bladder

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15
Q

BPH Treatment - medical

A

alpha blockers
- relax smooth muscle at the bladder neck

anti androgens
- prevent testosterone conversion

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16
Q

BPH Treatment - surgical

A

transurethral resection (TURP)

17
Q

What is the new BPH treatment?

A

prostate artery embolisation

18
Q

Prostate Cancer

A

second most common cancer in men which accounts for 1/4 of all cancers in men

a disease of elderly men occurring 1 in 10 men

unknown cause

19
Q

Aetiology of Prostate Cancer

A

unknown
- hormonal changes - androgens

  • family history
  • associated with BPH but no proof
20
Q

Pathology of Prostate Cancer

A

Adenocarcinoma

Mostly in peripheral zone, classically posterior location

Grading – Gleason Classification

Spread
- local or distant metastases

21
Q

Presentation of Prostate Cancer

A

Symptoms of lower urinary tract obstruction

Hard craggy prostate on rectal examination

Metastatic disease in the bone; pain

Asymptomatic carcinoma, found in autopsies

22
Q

Diagnosis of Prostate Cancer

A

Transrectal ultrasound: size & staging

Prostatic biopsy:
- histological diagnosis & Gleason scoring
- Prostate-specific antigen (PSA) - metastases

23
Q

Gleason Classification

A

grade 1-5 depending on glandular differentiation and architectural patterns

24
Q

Prostate Cancer Histology

A

Adenocarcinoma