Urology (prostate) Flashcards
Which Zone is most commonly affected in BPH
Transitional zone
Which zone is most commonly affected by cancer ?
Peripheral zone
Most common compositions of prostatic calculi ?
CaPO4 (calcium phosphate)
What is corpora amylacea?
They are lamellated bodies found in prostatic tissue and to thought to be precursor for prostatic stones
Most common organism responsible for acute bacterial prostatitis
E.Coli
PSA VALUES are not affected by……
DRE
What is removed in TURP
Central, Transitional and majority of the peripheral zone is removed leaving behind a portion of peripheral zone hence patient can still develop prostate cancer even after TURP from the remaining peripheral zone.
Nerve bundles, which are responsible for erection lies
Posterolateral to the capsule
Most common complication following TURP
Retrograde ejaculation
How does retrograde ejaculation patient presents with
No semen during intercourse however, semen comes out later in  urine
To prevent the incontinence during TURP, what should we do?
Veru montanum (bulge in prostatic urethra) is taken, as the distal limit of TURP
Why should prostatic massage is avoided in patient with prostatitis?
As it can lead to septicemia
Prostatodynia (dull perineal of pelvic pain) is a symptom of
Chronic prostatitis
Diagnosis of chronic prostatitis is made by
Three tube test (standard Meares and Stamey test)
If chronic prostatitis is because of chlamydia, which drug is used
Doxycycline
If chronic prostatitis is because of trichomonas , which drug is used
Metronidazole
What is urge incontinence?
Pass urine before reaching toilet
What is a enuresis
Nocturnal incontinence
Chronic retention of urine is said when ____ of residual uterine is present
250 CC
What is the first step in Management of Chronic retention of urine
Urgent catheterization
If PSA value is >3-4 ng/ml what should we do to differentiate BPH and Cancer
TRUS guided Trucut biopsy
Transperineal biopsy is done from which zone of the prostate
Anterior zone
Transrectal biopsy is done from which zone of the prostate
Posterior lobe (IOC)
Uroflometry and bladder pressure is used to differentiate between
Bladder obstruction and Neurogenic bladder
In BOO/BPH bladder pressure and urine flow rate are
Increased bladder pressure
Decreased flow rate
Urine flow rate and bladder pressure in neurogenic bladder are
Very low bladder pressure and
decrease flow rate
What is Marion’s disease / Prostatism sans prostate
It is due to hypertrophy of internal sphincter seen in young patients with clinical features of LUTS but prostate is Normal
What are the two components of BPH
STATIC : Testosterone —> DHT
DYNAMIC: mediated by α 1a receptor
Which drugs used in medical management of BPH
Alpha 1a blocker (Tamsulosin , Alfuzolin) and
5 α reductase inhibior (Finasteride,Dutasteride)
Alpha one blocker acts on on which component
Dynamic component
Five alpha reductase, inhibitor acts on which component
Static component
Which fluid are associated with increased incidence of TURP syndrome
Hypotonic fluid
What is the most common complication of TURP?
Hemorrhage
What is the most common vessels bleed during TURP ?
Badenoch’s artery
Badenoch’s artery arising from
Inferior vesicle artery (5 and 7 o’clock position)
TURP syndrome Is AKA
Water intoxication / dilutional, hyponatremia
What is the management of TURP syndrome?
If sodium is <120 mEq/L , then it is severe hyponatremia, (3% hypertonic saline infusion gradually),
if sodium is >120 mEq/L : fluid restriction
If more than 500 cc of glycemic gets absorbed, it can increase risk of
MI
Retropubic approach is also known as
Millin’s approach
Most common gene responsible for prostate, cancer is
GSTP-1 gene
What are the risk factors for prostate cancer?
Increasing age 90% chance if 90 years increase in testosterone
African-American
BRCA2 > BRCA1
obesity
What is the IOC for prostate cancer?
TRUS guided trucut biopsy
MC vertebral spread in Prostate cancer
Lumbar vertebrae
Bone scan should be done in prostate cancer if
Osteoblastic > Osteolytic
FPS > 10 ng/ML
Gleason’s score >/= 7
if symptomatic
Prostate cancer is an
Heterogeneous adenocarcinoma
In nerve preserving, RALP surgeries, which never is preserved, and why
Cavernous nerve because it is Responsible for erection
Name some of the anti-androgens drug
Flutamide
Enzulatamide
Abiraterone
Tumor marker for prostate cancer
PSA
A patient is planned for TRUS guided TRUcut biopsy OF prostate for suspected prostate cancer . how many cores should be taken while performing the procedure?
12
When should we carry out biopsy?
If PSA value is >3 with symptoms of had prostate 
If that is BPH how the prostate will feel on DRE
Firm rubbery mucosa
What is the normal value of PSA
0-3 ng/ml
What happens if we do rapid correction of sodium
Central Pontine demyelinosis
central Pontine myelinolysis
Most important prognostic factors for prostate cancer is
Stage of the disease
What are the storage symptoms?
Urgency
enuresis
frequency
What is the distal most border of the reception in TURP?
Verumontanum
What is the proximal limit of reception in TURP?
Bladder neck
What is the mechanism of retrograde ejaculation?
Description of the bladder leak
Which vaccine is used in the treatment of prostate cancer
Sipuleucel-T
Which laser is used in the laser in the enucleation of prostate
Ho-YAG laser
