Men's health Flashcards
(30 cards)
Define prostatitis
Inflammation of prostate gland. PTs are more likley to encounter patients with chronic prostatitis
In which population of men is the prevalence of prostatitis is at its highest?
Men <= 40 yrs old
What is the most common type of prostatitis?
Chronic prostatitis/ chronic pelvic pain syndrome (CP/ CPPS)
What are the potential causes of chronic pelvic pain syndrome?
- Urine reflux that stimulates an immune response
2. Pelvic floor dysfunction
Describe the clinical presentation for chronic prostatitis
- Low back and perineal pain
- Pain with prolonged sitting
- Voiding problems
- Sexual dysfunction
How is chronic prostatitis diagnosed?
- Urinalysis
2. Digital rectal exam (DRE)
How is chronic prostatitis differentiated from BPH and prostate CA?
Presence of Pain!
How is prostatitis prevented?
- Decrease time in seated position
2. If patient is a bicyclist, try different seats or change to a recumbent bicycle
How is prostatitis treated?
- Traditional: Anti-inflammatories, ABX, and skeletal muscle relaxants
- Physical therapy: Trigger point release, stretching and biofeedback of pelvic floor muscles
Define Benign prostatic hyperplasia (BPH)
Age-related NONMALIGNANT enlargement of prostate gland
Describe the pathogenesis of BPH
It’s unknown and probably age-related. However, multiple nodules comprised of proliferating cells progressively narrow the urethra
Describe the clinical presentation of BPH
- DECREASED force of urinary flow
2. Urinary frequency, nocturia
What are the treatment options for BPH?
- Monitoring, until symptoms progress
- Surgery: TURP = transurethral resection of prostate
- Medication
What are common medication classes for BPH and their function?
- 5-alpha-reductase inhibitors = shrinks prostate by 20%
2. Alpha-adrenergic blockers = relaxes smooth muscle in prostate, bladder, and urethra
What are the ADRs of alpha-adrenergic blockers?
Tachycardia, dizziness, orthostatic hypotension.
There is a potential for increased risk of falls!
Define prostate cancer
slow-growing malignant tumor of prostate gland
What are the risk factors for prostate cancer?
- Age > 50 yrs old
- Family or personal history
- High-fat diet
- Cadmium exposure
Describe the pathogenesis of prostate cancer
- Disorganized glands infiltrate stroma of prostate
- Tumors usually develop initially in periphery of prostate
- CA invades local structure
Prostate cancer often metastasizes in what areas?
- Lymph nodes
- Axial skeleton (spine, ribs, sternum)
- Lungs
- Liver
Describe the clinical presentation of prostate cancer
Early: No symptoms
Late: Urinary outflow obstruction, frequency, hesitance, nocturia, anemia, weight loss, and fatigue
How is prostate cancer prevented?
- Exercise
- Lycopene
These are associated with lower incidence
Metastatic lesion of prostate cancer usually occur where?
In axial skeleton, particularly thoracolumbar & sacral regions
When should you refer individuals with prostate cancer to a physician?
When back pain is not clearly associated with movement, and person reports urologic dysfunction; or, if patient has/ had prostatic cancer and has NEW back pain
What can be done for men who has had or going to have a radical prostatectomy?
Since incontinence is 100% immediately after catheter removal and most men regain control in 6 months (mean = 3 wk), pelvic floor re-education may speed recovery. Also, biofeedback and pelvic floor re-education before procedure may hasten recovery of urine control and decreased severity of incontinence.
