Bod: Male Repro: Normal Prostate Anatomy

Front 1

Approx weight of a normal prostate? Of a prostate with BPH?

Back 1

20 grams. 60-200 grams.

Front 2

What are the three zones of the prostate?

Back 2

Transition zone
Peripheral zone
Central zone

Front 3

What zone in the prostate surrounds the urethra?

Back 3

The transition zone

Front 4

What zone in the prostate surrounds the ejaculatory ducts?

Back 4

The central zone

Front 5

What cells of the prostate secrete a significant component of the seminal fluid?

Back 5

The tubulo-alvelor glands.

Front 6

The tubular-alveolar glands of the prostrate are separated by what?

Back 6

"An abundant fibromuscular stroma"

Front 7

What are the two cell types of the tubulo-alveolar glands of the prostate?

Back 7

Basal cells covered by a layer of columnar mucus secreting cells (epithelial cells).

Front 8

What are two substances that the epithelial cells of the tubulo-alveolar glands of the prostate produce?

Back 8

PSA (prostate specific antigen) and PAP (prostate acid phosphatase).

Front 9

What is a substance that the basal cells of the tubulo-alveolar glands of the prostate produce?

Back 9

High molecular weight cytokeratin (but not PSA or PAP)

Front 10

Does the prostate have a true capsule?

Back 10

No, it is a "peripheral condensation of fibromuscular stroma."

Front 11

What are the two most common begnign prostatic diseases?

Back 11

1. Benign prostatic hypertrophy
2. Prostatitis

Front 12

What is the characteristic morphology of benign prostatic hypertrophy?

Back 12

Characterized by glandular and stromal hyperplasia resulting in the formation of large nodules in the transition zone.

Front 13

BPH is extremely common in what demographic?

Back 13

In men over 60.

Front 14

What is considered to be the "ultimate mediator of prostate growth"?

Back 14

Dihydrotestosterone

Front 15

In what zone of the prostate does BPH occur?

Back 15

In the transition zone. (The hypertrophy in the transition zone compresses the urethra and the peripheral zone)

Front 16

BPH: clinical symptoms

Back 16

Compression of the urethra -->
Trouble emptying bladder
Urinary frequency
Trouble starting and stopping urination
Nocturia

Retention of urine --> distention, hypertrophy of the bladder, infection

Front 17

BPH: Surgical treatment

Back 17

Transurethral resection

Front 18

BPH: Medical treatment

Back 18

Blocking the action of androgens by preventing conversion to active form

Front 19

What are the three different classifications of prostatitis?

Back 19

1. Bacterial prostatitis
2. Nonbacterial prostatitis
3. Granulomatous prostatitis

Front 20

The types of organisms that cause prostatitis are similar to those that cause what other type of infection?

Back 20

UTIs

Front 21

Bacterial prostatitis: clinical symptoms

Back 21

- Fever and chills
- Lower back and perineal pain
- Dysuria
- Swollen, boggy, tender prostate

Front 22

Bacterial prostatitis: lab values

Back 22

- Urine culture positive (gram negative bacteria, 80% E. coli), > or = to 10 WBCs per high powered field.
- Leukocytosis

Front 23

Bacterial prostatitis: treatment

Back 23

ABX

Front 24

Bacterial prostatitis: microscopic presentation

Back 24

- Neutrophils
- Abcesses

*** for more see page 9

Front 25

Chronic bacterial prostatitis: clinical presentation

Back 25

- Recurrent UTIs (cystitis, urethritis)

- Swollen, boggy prostate

- Urine culture positive, > or = to 10 WBCs/high powered field. Leukocytosis.

Front 26

Chronic bacterial prostatitis: Treatment

Back 26

ABX

Front 27

Chronic bacterial prostatitis: microscopic presentation

Back 27

Lymphocytes in the lumina and epithelium.

Often associated with atrophy.

*** For more, see page 10

Front 28

Nonbacterial prostatitis: Clinical presentation

Back 28

- NO recurrent UTIs
- Low back pain, perineal pain
- Dysuria
- Rectal exam may be NORMAL!
- Urine culture NEGATIVE AND > or = to 10 WBCs/high powered field.

Front 29

Nonbacterial prostatitis: May occasionally find what on urine culture?

Back 29

Mycoplasma, chlamydia

Front 30

Nonbacterial prostatitis: microscopic presentation

Back 30

Microscopic presentation is the same as chronic bacterial prostatitis.

Front 31

Nonspecific granulomatous prostatitis: Rectal exam

Back 31

Nodular and hard, suspicious of carcinoma

Front 32

Nonspecific granulomatous prostatitis: Clinical presentation

Back 32

Obstructive symptoms
Recurrent infections
Age 50-70

Front 33

Nonspecific granulomatous prostatitis: Pathogenesis

Back 33

Duct obstruction --> accumulation of secretions --> rupture --> tissue response to leaked material.

Often associated with hyperplasia

Front 34

Nonspecific granulomatous prostatitis: granuloma formation

Back 34

No discrete granuloma formation

Front 35

Post-transurethral Resection Granulomatous prostatitis: Clinical presentation

Back 35

May be found in the prostate from 9 days up to 52 months following transurethral resection.

"Not clinically significant"

Front 36

Post-transurethral Resection Granulomatous prostatitis: Pathogenesis

Back 36

A reaction to aletered epithelium and stroma from the trauma of diathermic cautery.

Front 37

Post-transurethral Resection Granuloma of the Prostate: Microscopic findings.

Back 37

- Central zone of fibrinoid necrosis
- Rim of palisades epithelioid histocytes
- Varied number of multinucleated giant cells

Front 38

What is BCG used for?

Back 38

For treatment of superficial urothelial bladder carcinoma (most common cancer of the bladder)

Delays the recurrency of superficial urothelial bladder carcinoma.

Front 39

What is the reaction of the body if BCG is injected.

Back 39

Granuloma formation.

Front 40

Post-BCG Treatment Granulomas of the Prostate: Clinical presentation

Back 40

- Follows BCG treatment for superficial urothelial bladder carcinoma

- Fever, mild hematuria, urinary frequency

- 40% have abnormal rectal exam
- 55% have abnormal ultrasonographic abnormalities.

- PSA is elevated