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Flashcards in Male Urology Deck (155)
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1

What type of tissue comprises 30% of the prostate?

What comprises the other 70%?

30%: Glandular tissue

70%: Stroma

2

What is the smallest structural component of glandular prostate?

Acini

3

T/F: Proliferation of the acini results in BPH

True

4

Proliferation of the ________ (Acini/Basement Membrane) of the prostate leads to prostate cancer

Basement Membrane

5

What are the three zones of the prostate?

Central Zone
Transitional Zone
Peripheral Zone

6

Which zone of the prostate contains mucosal and submucosal glands?

Changes in this zone often lead to urethral pressure.

Periurethral Zone

7

Which zone of the prostate contains the majority of prostatic glandular tissue and is the origin site for most adenocarcinomas of the prostate?

Peripheral Zone

8

Which zone of the prostate is often described of as the "cone shaped" portion of the prostate?

Central Zone

9

T/F: The transitional zone of the prostate does NOT surround the urethra

False

It does surround the urethra

10

What percentage of men have BPH by the age of 60?

80?

60: 50%

80: 90%

11

What is the mechanism for BPH development?

Testosterone is broken down by 5alpha-reductase to form DHT

DHT then binds to nuclear receptors in the prostate leading to BPH

12

What receptors in the prostate (near the bladder neck) result in smooth muscle contraction leading to LUTS associated with BPH?

A1-Adrenergic Receptors

13

What are examples of obstructive LUTS?

Weal Stream
Hesitancy
Incomplete Emptying
Double voiding

14

What are examples of irritative LUTS?

Urgency
Frequency
Nocturia

15

What are FOUR key components to a BPH work-up?

DRE
UA
BMP
Baseline PSA

16

What 'imaging' study can be obtained to see if a patient is retaining urine?

PVR (Post-Void Residual)

17

What is the name of the 'imaging study' used to measure how strong a patient's urine stream is?

Uroflow

18

What is the name of the procedure used to visual the inside of the bladder?

Cystoscopy

19

What may the appearance of the bladder be described as if it has been squeezing hard against the prostate?

Trabeculated

20

What medications used in BPH management "open up" the prostate through smooth muscle relaxation?

Alpha Blockers.....

Non-Selective: Terazosin (Hytrin), Doxazosin

Selective: Tamsulosin (Flomax), Silodosin (Rapaflo)

21

What medications used in BPH management "shrink" the prostatic glands?

%-alpha reductase inhibitors.....


Finasteride
Dutasteride

22

What is an antimuscarinic used in BPH management?

Oxybutynin

23

What are examples of surgical procedures used to manage BPH?

TURP
TUNA
TUMT
PVP

24

T/F: Recurrent UTIs attributable to BPH is NOT an indication for surgical management

False

It is an indication

25

T/F: Prostate CA is the 2nd leading cause of cancer death in US men

True

26

What are two crucial screening tools for prostate cancer?

PSA
DRE

27

What is the normal PSA range?

0.0 - 4.0

28

What are three examples of things that lead to a benign elevation in PSA?

Trauma
Instrumentation
Ejaculation

29

T/F: You should always trend PSA values prior to jumping to conclusions or management decisions (ie: Biopsy)

True

30

A 75 y.o. male presents for annual screening. He denied any urinary symptoms but has been noticing himself get sweaty at night. His exam is unremarkable other than an enlarged nodular prostate on DRE. Upon review of his annual labs you notice that his PSA is trending up and most recently is at 8.9.

What is your most concerning diagnosis and how is this diagnosed?

Prostate Cancer

Diagnosed through a prostate biopsy with transrectal US guidance