Prostate, LUTS, Prostate Conditions

Where is the prostate?

• Walnut-sized gland below bladder

Why does the PROSTATE cause urinary problems?

• Urethra passes through middle

• Gland grows throughout adult life

• Enlarging prostate compresses urethra

• Bladder works harder

• Detrusor thickens, becomes irritable, eventually fatigues

Why do prostate problems cause both irritative and obstructive symptoms?

• Obstructive symptoms = blockage

• Irritative symptoms = overworked bladder

Where is the prostate located in relation to the rectum?

• Directly in front of rectum

• Can be palpated on DRE

What are the IRRITATIVE LUTS?

• Frequency = "going constantly"

• Urgency = "have to go right now"

• Nocturia = up 5-6 times/night

What are the OBSTRUCTIVE LUTS?

• Weak stream = "it doesnt come out like it used to"

• Intermittency = "Starts then stops"

• Straining = "I have to push to get it going"

• Emptying incomplete = Dribbling afterward

What is PROSTATITIS

• Inflammation/infection, most often bacterial

Prostatitis findings?

• Fever/chills

• Perineal pain

• Dysuria

• Frequency

• Urgency

• WBCs/nitrites

• DRE: warm, swollen, tender, boggy

• PALPATE GENTLY

What is BPH

• Noncancerous prostate enlargement

BPH findings

• Obstructive + irritative LUTS (FUNWISE)

• Usually normal UA, may have hematuria

• DRE findings: enlarged, smooth, symmetric, nontender, no nodules • Common with age

• NOT a risk factor for prostate cancer

Early PROSTATE CANCER characteristics

• Malignancy of prostate

• Often NO symptoms

• Silent until advanced

• Usually normal UA

• DRE findings: hard, irregular, nodular, asymmetric, or may be entirely normal