prostate disorders Flashcards by Rachel Lagerstrom

what is prostatitis?

inflammation of the prostate

How well did you know this?

Not at all

Perfectly

symptoms of prostatitis mimic …

UTIs and other prostate disorders

How well did you know this?

Not at all

Perfectly

prostatitis includes 25% of all visits regarding GU concerns in what age group of men?

young/middle aged

How well did you know this?

Not at all

Perfectly

symptoms of acute prostatitis?

very symptomatic, sudden onset of fever, chills, LBP, body aches, perineal pain

How well did you know this?

Not at all

Perfectly

causes of acute prostatitis

overgrowth of bacteria normally found in prostatic fluid (ie E. coli)

How well did you know this?

Not at all

Perfectly

physical exam findings in acute prostatitis

tender, swollen indurated prostate, purulent secretions, bacteriuria

How well did you know this?

Not at all

Perfectly

lab findings for acute prostatitis

WBCs and bacteria in urine/prostate fluid w/ acute onset and systemic Sx

How well did you know this?

Not at all

Perfectly

treatment for acute prostatitis

*ER referral; antibiotics 7-10 days

How well did you know this?

Not at all

Perfectly

symtpoms of chronic prostatitis

asymptomatic to suprapubic pain or LBP, intermittent as it waxes and wanes

How well did you know this?

Not at all

Perfectly

causes of chronic prostatitis are..

bacterial (: from acute prostatitis, Chlamydia, ureaplasma urealyticum, underlying
anatomical variant harboring bacteria) or non-bacterial (unknown-dx by exculsion)

How well did you know this?

Not at all

Perfectly

lab findings with chronic prostatitis

bacterial: WBCs and bacteria in urine/prostate fluid w/insidious onset
non-bacterial: may see WBCs in urine or prostate fluid, but no evidence of infection

How well did you know this?

Not at all

Perfectly

treatment for chronic prostatitis

bacterial: antibiotics 4-12 wks, NSAIDS, Sitz baths

non-bacterial: NSAIDS, natural anti-inflamm., relax tissue

How well did you know this?

Not at all

Perfectly

symptoms with both chronic and acute prostatitis

tender swollen prostate, dysuria, nocturia, urgency, hesitancy, frequency,
hematuria, pelvic/ab pain, LBP, joint/muscle pain, painful ejaculation

How well did you know this?

Not at all

Perfectly

risk factors with both chronic and acute prostatitis

catheterization, unprotected sex, abnormal urinary tract,

recent cystitis, BPH, DM, immunocompromised

How well did you know this?

Not at all

Perfectly

dx with both chronic and acute prostatitis

prostatic stripping and culture discharge, WBCs in discharge is not
diagnostic, pH of fluid rises w/ infection, pre/post massage collection of urine for
culture, PSA levels elevated
• DRE looking at size, symmetry, consistency, lumps/nodules,
discomfort/pain

How well did you know this?

Not at all

Perfectly

what is prostadynia

chronic pelvic pain syndrome (CPPS)

How well did you know this?

Not at all

Perfectly

symptoms/signs of prostadynia

similar to prostatitis but without inflammation or bacterial infection, pain in pelvis/perineum and extends to penis/testes/rectum, may cause voiding or sexual dysfunction

causes of prostadynia

unknown (msl spasm? nerve entrapment?)

tx of prostadynia

Finesteride used w/ BPH may reduce Sx

pudendal nerve entrapment (PNE) causes include

impact trauma, surgery, congenital malformations

Pudendal nerve is predisposed to entrapment at

the level of ischial spine and within the pudendal canal

signs and symptoms of pudendal nerve entrapment

pain in penis/scrotum/perineum/anorectal, prostatitis-like pain and voiding/sexual dysfunction are hallmark of PNE, aggravated by sitting, relieved by standing/lying down

how is pudendal nerve entrapement diagnosed

a clinical diagnosis, imaging is not necessarily helpful, r/o causes of
prostatitis

treatment for pudendal nerve entrapment

DC evaluation for MSK issues, acupuncture, PT, meds/supplements,
decompression surgery.

is BPH precancerous?

who most commonly gets BPH

african americans; condition of aging

causes of BHP

unknown, hormonal influence?

where does hyperplasia occur with BPH

in transitional zone starting around prostatic urethra

symptoms of BPH only occur in ___% of patient

what are some symptoms with BPH that can occur?

Partial obstruction of lower urinary tract: difficulty initiating urine stream (hesitancy), interruption of stream, frequency, urgency, nocturia

what are common PE findings with BPH, cancer, and prostatitis?

BPH → non-tender, soft, boggy. CA → rock-hard. Prostatitis → painful.

dx for BPH done by

DRE, AUA symptom index questionnaire

labs for BPH? (what to be wary of..)

PSA. But PSA is elevated with: BPH, prostate CA, recent ejaculation or DRE (~2 days) and prostatitis.

with PSA lab test, what is normal and what is more important to look for

: increases w/ age so normal values vary (0-4.0 ng/mL is normal). More important is the “velocity” that PSA increases.

what are complications of BPH

decreased quality of life and ADLs, residual urine can cause UTIs and acute urinary retention → ER referral, complete obstruction which would require surgery

do BPH complications increase risk of developing prostate cancer?

when should you refer a patient with BPH

when patients need transrectal US guided biopsy

what are medications for BPH

5-alpha-Reductase Inhibitors (Finasteride/Proscar) → inhibits testosterone conversion to DHT. Alpha-blockers → relax smooth muscle

when should a patient with BPH get surgery

for those with more serious complications. TURPs to make a pathway so they can pee again

what are some alternative natural options for patients with BPH

Saw Palmetto (160 mg 2x/day) to improve urine flow and decrease Prevents estrogen from binding r/cs. Inhibits conversion of testosterone to DHT. • Amino acids, beta-sitosterol, zinc picolinate, pygeum bark, nettles

how is Saw Palmetto different than medications (what does it not affect?)

Sx; does not affect PSA like meds and does not seem to interfere w/ PSA measurements.