Exam 3 Study Material for Systems Pathology - Prostate (Pages 47-77)

area that surrounds the ejaculatory duct

central zone

largest area of the prostate, easily felt by doctor during digital rectal exam, location where most prostate cancers start

peripheral zone

area that surrounds the urethra as it enters the prostate gland

transitional zone

finger palpation through the anal canal and rectum to examine the prostate gland

digital rectal exam (DRE)

swelling and inflammation of the prostate gland

prostatitis

Who is prostatitis common in?

50 years ad younger

signs/symptoms of prostatitis (depending on cause) include:

dysuria, difficulty urinating, frequent urination (night)

Acute bacterial prostatitis/chronic bacterial prostatitis account for what % of prostatitis (each)?

2-5%

MC cause of bacterial prostatitis

E. coli (or other uropathogens)

how can bacteria enter the prostate to induce bacterial prostatitis?

hematogenous, descending (bladder/kidneys), ascending (urethra), lymph, rectum

signs/symptoms of bacterial prostatitis

LBP, pelvic pain, dysuria, fever, chills, tender DRE

what accounts for 90-95% of prostatitis?

chronic nonbacterial prostatitis (prostatodynia/chronic pelvic pain syndrome)

3 types of symptoms of chronic nonbacterial prostatitis

pain upon urination, urinary voiding difficulties, sexual dysfunction

what will show up on a urinary sample of someone with the bacterial form of prostatitis?

bacteria and WBC

what will show up on a urinary sample of someone with the nonbacterial form of prostatitis?

WBC only

NIH outcome measures or chronic nonbacterial prostatitis?

pain, urinary symptoms, quality of life impact

tx for chronic nonbacterial prostatitis

antibiotics, anti-inflammatory, alpha blockers (3 A's)

what area of the prostate does benign prostatic hyperplasia (BPH) typically occur?

transitional zone

cause of BPH

idiopathic, androgen related increase in estrogens (expresses DHT and encourages prostatic growth)

onset of BPH is usually ____ years but around 90% of males > ____ years have it

40 ; 70

only 10% of BPH is symptomatic and symptoms usually consist of:

urethral obstruction (difficulty starting/maintaining stream, increase frequency, nocturia)

1st round of tests to diagnose your patient with BPH

digital rectal exam, urine and blood test, PSA test (will be increased)

treatment for BPH is dependent on what factors?

size of prostate, age, overall health, discomfort

most common treatment for mild to moderate symptoms of prostate enlargement

medication (alpha blockers, 5-a reductase inhibitors, both)

does the size of your prostate determine severity of your symptoms?

no

MC type of surgical therapy for BPH

TURP

consequences of surgical intervention for BPH

incontinence, erectile dysfunction

most common cancer in American men ; second leading cause of cancer death among American men

prostate

who is prostate cancer more likely to develop in?

older men, non-hispanic black men, usually 65+

most common prostate cancer which forms in glandular tissue, is a firm mass with ill-defined borders, and may be palpable

adenocarcinoma

most common location for prostate cancer

peripheral zone

risk factors for developing CA of the prostate

>50 years (MC 65-75), African Americans, family Hx, obesity, African Americans

symptoms of CA of the prostate (usually only s/s when advanced)

trouble urinating, blood in urine/semen, bone pain, losing weight without trying, erectile dysfunction

Where does prostate cancer metastasize to?

spine (bright white)

Increased PSA indicates

prostate cancer, BPH

Does the USPSTF recommend PSA-based screening for cancer in men age 70+?

no

regular or repeated inability to obtain or maintain an erection firm enough for sex

erectile dysfunction