Neoplasm of Prostate Gland

Prostate gland

male organ most commonly afflicted with either benign or malignant

Base of bladder

Reproductive (produce the semen)

Prosate Gland

Location:

Function:

20 grams

Normal prostate gland size

>25

Considered hypertrophy _____ grams

Hyperplastic Process

refers to an increase in the number of cells in a tissue or organ, leading to its enlargement.

Direct Rectal Examination (DRE)

determine if prostate is enlarged.

Voiding Problem

Moderately Symptomatic

Most common presentation of Bening Prostatic Hyperplasia (2)

Interpretation

1. Mildly Symptomatic = 0 to 7

2. 2. Moderately Symptomatic = 8 to 19

3. Severely Symptomatic = 20 to 35

Interpretation

1. Mildly Symptomatic =

2. 2. Moderately Symptomatic =

3. Severely Symptomatic =

Frequency

Urgency

Nocturia

Weak Stream

Intermittency

Straining

Emptying

FUNWISE

0 to 4 ng/mL

Normal Value of Serum PSA

PSA

To rule out cancer of the patient

Ultrasound

Standard of Choice in BPH

Cytoscopy

used to visualize the bladder, urethra, and prostate to assess the severity of obstruction caused by an enlarged prostate.

Verumontanum

• small, elevated ridge found in the posterior urethra (prostatic urethra),

  near the center.

• It is an important anatomical landmark in the prostate

TURP (Transurethral Resection of the Prostate)

GOLD STANDARD for treatment of BPH

> 80 grams

Size of the prostate that needs surgery

Other Options aside from surgery

Laser surgery

Holmium Laser Enucleation of the Prostate (HoLEP)

Water Vapor Therapy

Other options aside from surgery

Tamsulosin (Flomax)

Most commonly prescribed, selective for the prostate.

Alfuzosin (Uroxatral)

Good for patients with lower risk of side effects

Terazosin (Hytrin)

Similar to Doxazosin but may cause dizziness.

5-ARI (5-Alpha Reductase Inhibitors)

medications that shrink the prostate by blocking the conversion of testosterone to dihydrotestosterone (DHT)

5 o’clock position and 7 o’clock position

Site of incision

TNM Staging System

used to determine the extent of cancer spread and guide treatment decisions.

T1 - Tumor not palpable

T2 - Tumor is palpable but not confined to the prostate

T3 - Tumor extend beyond prostate capsule

T4 - Tumor invades nearby structures

TNM Staging System

T1

T2

T3

T4

N – Nodes (Lymph Node Involvement)

• N0 – No regional lymph node metastasis.

• N1 – Spread to regional lymph nodes.

• N2 – Spread to one or more regional lymph nodes

• N3 – Cancer spread to a lymph node and is larger than 5 cm

N – Nodes (Lymph Node Involvement)

• N0 –

• N1 –

• N2 –

• N3 –

M0 – No distant metastasis.

M1 – Distant metastasis present in the lymph

nodes (outside of the pelvis), bones, or other

distant organs such as lungs, liver or brain.

M – Metastasis (Distant Spread)

M0

M1

Lumbar Spine

First stop of the cancer

Serum PSA

Prostate specific but not prostate cancer specific

Protastectomy

Everything is removed including seminal vesicles and the Lymph Nodes

Prostatitis

Urologic condition involving inflammation of the prostate

Affects young men and older men

Acute bacterial prostatitis (ABP) (TYPE 1)

caused by ascending UTI

(acute means 1 week/2weeks)

Chronic bacterial prostatitis (CBP) (TYPE 2)

• caused by recurrent UTIs and previous ABP

• may involve bacterial biofilms

• > 1 month

Chronic Sterile Inflammation A.k.a. Chronic Pelvic

Pain Syndrome (CPPS) (TYPE 3)

• Caused by reflux of urine within the prostate

• Most common

Type 4

Asymptomatic inflammatory prostatitis

NO SYMPTOMS

Tamsulosin

To relax bladder neck