Diseases of prostate

Question 1

Most common effect on prostate due to aging

Answer 1

atrophy

*but not really a condition

Question 2

Prostatic diseases

• causes
• signs

Answer 2

1. Inflammation
2. Hyperplasia
3. Neoplasia

Nl asymptomatic until advanced

Symptoms when present are usually those of urethral obstruction or irritation

Question 3

causes of Acute prostatitis

Answer 3

1. Enterobacter (E. coli)
   S. aureus
2. Direct extension from urinary tract
3. Iatrogenic (hospital)

Question 4

Benigns prostatic hyperplasia (BPH)

Answer 4

most common proliferative disease of the prostate

• benign nodular enlargement of prostate

Blacks>whites> Asians

More common the older you get

Lower urinary tract symptoms most common
- quality of life impact

Question 5

Complications of BPH

Answer 5

1. Acute urinary retention
2. Recurrent UTI/pyelonephritis
3. Renal failure
4. Incontinence

*mainstay tx is medical

Question 6

Most common non-skin cancer of adult males

Answer 6

prostatic carcinoma
(1 in 5 , 20% of all male cancers)

• second leading cause of male cancer deaths (behind lung)

Question 7

Prostatic cancer risk factors

Answer 7

Age
Race (black, then white)
Genetics

*and a shit ton of others

Question 8

Prostatic carcinoma affects which zones more?
Gold std for diagnosis?
Are these usually solitary or multifocal?

Answer 8

Peripheral zone > transition zone

Blind “random” biopsies
- can miss tumor due to heterogeneity of tumor

Multifocal

• tumor can very quickly arise as high grade lesion
• need to treat low grade tumor

Question 9

Prostatic intraepithelial neoplasia

Answer 9

noninvasive precursor to some prostate cancers (30-50%)

- genetic and molecular changes similar to PCa

Question 10

Gleason grading

Answer 10

Grading for Prostatic adenocarcinoma

• stage correlates with morphology
• higher stage = higher mortality
• lack of glandular epithelium is hallmark of pathology