Disorders Of The Prostate Flashcards
(31 cards)
What is prostatitis?
Inflammation of prostate
What organisms cause acute + chronic prostatitis?
E. coli
Staphylococcus species
STIs pathogens
Most common pathogen of acute bacterial prostatitis
E coli
Describe acute prostatitis
Acute flare up of inflammation of prostate
Risk factors of acute bacterial prostatitis
- recent UTI
- urogenital instrumentation
- intermittent bladder catherisation
- recent prostate biopsy
Symptoms of acute prostatitis
- malaise
- rigors
- fever
- difficult passing urine
- dysuria
- perianal tenderness
What is found on a rectal exam of acute prostatitis?
Soft, tender + enlarged prostate
Investigations of prostatitis
- urine dipstick
- urine microscopy, culture + sensitivities
- chlamydia + gonorrhoea NAAT testing
- DRE
Management of acute bacterial prostatitis
- oral abx for 2-4 weeks e.g. ciprofloxacin, trimethoprim
- analgeisa e.g. paracetamol or NSAIDs
- laxatives - to help with painful bowel movements
Complications of acute bacterial prostatitis
- sepsis
- prostate abscess
- acute urinary retention
- chronic prostatitis
What does chronic prostatitis result from?
Inadequately treated infections
As antibodies cannot penetrate prostate effectively
Presentation of chronic prostatitis
- pelvic pain
- lower urinary tract symptoms - dysuria, hesitancy, frequency
- sexual dysfunction e.g. ED, pain on ejaculation, haematospermia
- pain with bowel movements
Diagnosis of chronic prostatitis
- neutrophils, plasma cells + lymphocytes in histology
- positive culture from sample of prostatic secretion
What is the most common type of prostatitis?
Chronic non bacterial prostatitis
Common history of patient with chronic prostatitis
Recurrent parasitic or urinary tract infections
What organism typically causes chronic non-bacterial prostatitis?
Chlamydia trachomatis
Management of chronic prostatitis
- alpha blockers e.g. tamosulin
- analgesia
- abx if infection suspected e.g. trimethoprim or doxycycline for 4-6 weeks
- laxatives - to help with painful bowel movements
What is benign prostatic hypertrophy/hyperplasia?
Non-neoplastic enlargement of prostate gland
Presentation of BPH
- difficulty or hesitancy to start urination
- poor stream
- dribbling post micturition
- frequency
- nocturia
- intermittency
- feeling of incomplete emptying
Investigations of BPH
- DRE
- abdominal exam
- urinary frequency volume chart for 3 days
- urine dipstick
- PSA
BPH on a DRE
Firm, smooth + rubbery prostate
Treatment of BPH
- alpha blockers: relaxes smooth muscle at bladder neck + within prostate e.g.tamsulosin
- 5a reductase inhibitors: prevents conversion of testosterone to dihydrotestosterone > shrinks prostate e.g. finasteride
- transurethral resection of prostate
What can untreated BPH present with?
Acute urinary retention
Distended + tender bladder
Desperate urge to pass urine
Differentiate the digital rectal exam findings of prostatitis, BPH + prostate cancer
- prostatitis: soft, tender + enlarged
- BPH: firm, smooth + rubbery
- prostate cancer: hard + irregular
