Flashcards in Disorders of the Prostate and Treatment Deck (38)
most common benign tumor in men
What happens pathophysiologically as the prostate gland enlarges?
Increased resistance to urine flow leads to bladder muscle hypertrophy. Predisposes to infection
What are the irritative symptoms of BPH?
frequency, nocturia, urgency
Obstructive symptoms include: hesitancy, weak stream, incomplete emptying, straining, dribble
What labs should you order for BPH?
UA, Cr, PSA
When is imaging such as IVU, IVP, CT or renal ultrasound ordered to evaluate BPH?
recommended only in the presence of concomitant urinary tract disease, or complications from benign prostatic hyperplasia
Medication primarily used for symptomatic relief of BPH
Medication class used to reduce prostate size
Most common alternative supplement for BPH
What are the treatment recommendations for a man who has AUA score <7?
watchful waiting (limit fluids after dinner, avoid decongestants, void frequently)
Indications include refractory acute retention, hydronephrosis, repeated UTIs, recurrent or refractory gross hematuria, or elevated Cr level that responds to catheter drainage
Most common surgical procedure for BPH
Common complication of transurethral prostatectomy
Retrograde ejaculation resulting in infertility
Better surgical option for younger men with smaller prostates; reduces risk for retrograde ejaculation and subsequent infertility
Transurethral Incision of the Prostate (TUIP)
Most common cancer detected in american men and second leading cause of cancer related death. 'Merica!
Clinical findings suggestive of prostate cancer
induration at time of DRE and elevated PSA
Most common site of prostate cancer metastases
standard method for detection of prostate cancer. Taken from the apex, midportion and base of prostate
Most frequently used to stage prostate cancer
When should you order a bone scan for prostate cancer?
those with advanced local lesions, symptoms of mets, high grade prostate cancer and PSA’s >20
Stage of cancer where tumor is microscopic and confined to prostate but is undetectable by a digital rectal exam (DRE) or by ultrasound
Stage of cancer where Tumor is confined to prostate and can be detected by DRE or ultrasound
Stage of cancer when it has spread to tissue adjacent to the prostate or to the seminal vesicles
stage T3 or T4
Stage of cancer when it has spread to pelvic lymph nodes, lymph nodes, organs, or bones distant from the prostate
N+ or M+
What stage tumors are candidates for curative therapy with either radiation therapy or radical prostatectomy. Usually external beam radiation therapy
T1 or T2
Benefits of external beam radiation therapy
lower risk of erectile dysfunction and incontinence
involves placing radioactive, rice-sized pellets directly into the prostate gland; the radiation is emitted from within the gland for a specified period of time and then dissipates
Abx treatment for acute bacterial prostatitis caused by STD
A shot of ceftriaxone followed by a 7-day course of doxycycline
Common symptoms of acute prostatitis that are often not present with chronic prostatitis
perineal pain and exquisite tenderness of the prostate