Urology Flashcards
weight of a healthy prostate?
20grams
where is the prostate located anatomically?
Inferior to the bladder neck
anterior to the rectum
what is the arterial supply of the prostate?
internal iliac artery -> inferior vesical artery -> prostatic arteries -> urethral and capsular arteries
venous drainage of the prostate?
prostatic plexus near dorsal vein -> internal iliac vein-> IVC
lymphatic drainage of the prostate?
obturator and internal iliac channels
which part of the prostate is the origin for most prostate cancers?
peripheral zone of prostate
which part of the prostate is responsible for BPH?
transitional zone of prostate
where increased number of cells in BPH
what is the physiological function of the prostate?
to make seminal fluid to aid sperm passage
prevents retrograde ejaculation by acting like a sphincter
what are the properties of seminal fluid that aid it in assisting passage of sperm?
alkaline
contains fructose
prostaglandins
clotting factors
LUTS symptoms refer to symptoms caused by pathology from which part of the urethral tract?
from the bladder down
what are the 2 categories of LUTS symptoms?
storage
voiding
what are the storage symptoms of LUTS?
Frequency
Urgency
Nocturia
What are the voiding symptoms of LUTS?
Weak stream
Intermittency
Straining
Emptying incompleteness
BPH red flags/other sx:
bone pain weight loss haematuria infection incontinence pain sexual dysfunction
why is family history important when suspected BPH?
BRCA gene linked
3 times when you wouldn’t do a DRE:
no consent
,<16yo
neutropenic sepsis
what is the difference between hyperplasia and hypertrophic?
hyperplasia - increased number of cells - increased size of tissue
hypertrophic - increased size of cells
definition of BPH:
histological diagnosis reflecting:
- hyperplasia/hypertrophia
- bladder outlet obstruction
- LUTS
aetiology of BPH:
age-related hormone changes
hyperplasia of transitional zone cells
vascular/inflammatory event
metabolic syndrome
pathophysiology of BPH:
mechanical fault or smooth muscle pathology -> detrusor overactivity (bladder smooth muscle)
which category of LUTS is commoner?
voiding
what are the complications of BPH?
persistent UTIs
incontinence
urinary retention
what investigations would you do for BPH:
bloods - glucose, HbA1c, PSA
urinalysis
?USS
special tests
what special tests would you do to ix BPH?
flow studies frequency-volume chart IPSS score - sx, QOL score -> mild/mod/sev cystoscopy Urodynamics