all about prostate n BPH

1. BY,
SHARMEEN SHAKOOR

2.  The prostate is a walnut-sized gland located
between the bladder and the penis.
 The prostate is just in front of the rectum.
 The urethra runs through the center of the
prostate, from the bladder to the penis,
letting urine flow out of the body.
 The prostate secretes fluid that nourishes and
protects sperm. During ejaculation, the
prostate squeezes this fluid into the urethra,
and it’s expelled with sperm as semen

4.  The prostate gland is divided into :
 Peripheral zone.
 Central zone.
 Transition zone

5.  Glandular cells
 Smooth muscle cells
 Stromal cells
 The prostate gland also contains an enzyme5
alpha-reductase type-2 that
convertstestosterone to Dihydrotestosterone
(morepotent)

6.  Enlarged prostate i.e Benign prostatic
hyperplasia
 Prostate cancer
 Prostatitis

7.  Benign prostatic hyperplasia (BPH) is the
enlargement of the gland .
 As the prostate starts to enlarge it exerts
pressure on the walls of the urethra.

9.  The exact etiology of BPH is still poorly
Understood.
 In BPH there is decrease in testosterone level
with advancing age but estrogen level does
not decrease equally.
 Inc in estrogen level causes hypertrophy of
prostate.
 DIHYDROTESTOSTRONE is main mediator of
BPH.

10. Symptoms related to urine storage in the
bladder are the following:
 Frequent micturition.
 Nocturia (nocturnal urination).
 Urinary urgency.
 Urge incontinence

11. Symptoms related to urine voiding from the
bladder are the following:
 Reduction in urine flow and force.
 Intermittent micturition.
 Leak of urine drops after the end of
micturition
 Feeling of incomplete bladder voiding.
 Urine retention.
 Dribbling.

12.  history
 Physical examination :
• digital rectum test
• palpate
 PrUrinalysis
 Uroflowmetry
 Cystoscopy
 Ultrasound
 prostate Specific Antigen (PSA) Test

14.  How often have you had a sensation of not emptying your
bladder completely after you finished urinating?
 How often have you had to urinate again less than two
hours after you finished urinating?
 How often have you stopped and started again several
times when you urinated?
 How often have you found it difficult to urinate?
 How often have you had a weak urinary stream?
 How often had you had to push or strain to begin
urination?
 How many times did you most typically get up to urinate
from the time you went to bed at night until the time you
got up in the morning?


17.  Prostatitis
 Bladder obstruction
 Bladder cancer
 Neurogenic bladder

18.  Watching waiting
 Home plan
 Medications :
 surgery

20.  the prostate cancer starts in the gland cells -
this is called adenocarcinoma.
 prostate cancer starts with tiny alterations in
the shape and size of the prostate gland cells.
Prostatic intraepithelial neoplasia (PIN).
 Prostatic intraepithelial neoplasia means
"dysplastic changes involving glands and
ducts of the prostate that may be a precursor
of adenocarcinoma

21.  Most prostate cancers are slow growing;
however, there are cases of aggressive
prostate cancers
 If the tumor is within the gland, the cancer is
said to be localized and curable
 If the cancer escapes the gland it is
considered incurable
 Early detection before the cancer escapes the
gland becomes very important

22. - Age
- Genetics
- Faulty BRCA2 gene linked to aggressive.
- Diet
- Medication
- Obesity
- STDs
- Agent orange
- Enzyme PRSS3 linked to aggressive

23.  Stage I
 Stage II
 Stage III
 Stage IV

25. During the early stages:
 The patient urinates more often
 The patient gets up at night more often to
urinate
 He may find it hard to start urinating
 He may find it hard to keep urinating once he has
started
 There may be blood in the urine
 Urination might be painful
 Ejaculation may be painful (less common)
 Achieving or maintaining an erection may be
difficult (less common)

26.  Bone pain, often in the spine (vertebrae),
pelvis, or ribs
 The proximal part of the femur can be painful
 Leg weakness (if cancer has spread to the
spine and compressed the spinal cord)
 Urinary incontinence (if cancer has spread to
the spine and compressed the spinal cord)
 Fecal incontinence (if cancer has spread to
the spine and compressed the spinal cord)

27.  Metastasis
 Incontinence
 Erectile dysfunction
 Metabolic factors

28.  A 60-year-old black man presents to his general
practitioner with complaints of difficulty with
urination. He describes a weak stream and a
sense of incomplete voiding. He describes
nocturia (5 episodes per night) and has been
taking an alpha-blocker for this with minimal
improvement. He says he can last about 60 to 90
minutes without urinating. He denies any
suprapubic tenderness, dysuria, or haematuria.
He further denies any back pain or
gastrointestinal complaints.

29.  PSA test blood test
 Prostate biopsy
 Transrectal ultrasound
 Bone scan
 CT
 MRI
 ProstaScintTM scan

31.  Prostatitis
 BPH

32.  Medication
 Watchful waiting
 Prostatectomy
 Radiation placed inside your body
(brachytherapy)
 Radiation that comes from outside of your body
(external beam radiation)
 Hormonotherapy
 Chemotherapy
 Freezing prostate tissue
 Heating prostate tissue using Ultrasound
 cryotherapy

34.  Prostatitis is inflammation caused by an
infection of the prostate.
 Treated with antibiotics