Benign Enlargement Of The ProstatePresentation Transcript
Dr Soumar Dutta Guwahati Refinery Hospital
The prostate is an accessory gland of the male reproductive system. The secretions of this gland add bulk to the seminal fluid. Shape: Inverted cone Apex, base & 4 surfaces Size: 4cm X 3cm X 2cm Weight: 8 Gm Consistency: Firm Lobes: 5 Histological 3 zones outer /peripheral middle/transitional inner/central
(I) Hormonal Theory
(II) Neoplastic Theory
Pathogenesis : Hyperplasia of both glandular epithelium and connective tissue stroma forming one or more nodules. May involve any part of the gland with the exception of ant. and post. lobes. May compress the rest of the gland forming a false/surgical capsule.
Changes in the urethra : enlargement of the prostatic urethra exaggeration of the normal posterior curvature of the prostatic urethra urethra compressed laterally reducing it to an A-P slit Changes in the urinary Bladder: Compensatory hypertrophy of the vesical detrussor Trabeculation of bladder wall. Hypertrophy of the trigone. Formation of diverticula Formation of pool of residual urine- cystitis,calculus[triple PO4] Changes in ureters and kidney: Hydroureter and Hydronephrosis Vesicoureteric reflux- Ac. & Chr. Pyelonephritis
BEP seldom causes symptoms before 50 yrs of age
No direct relation between the degree of enlargement and severity of symptoms.
Earlier prostatism term now replaced by “LUTS”.
OBSTRUCTIVE IRRITATIVE . Hesitancy . Frequency
. Poor flow . Nocturia
. Intermittent stream . Urgency
. Dribbling . Urge Incontinence
. Sense of incomplete evacuation . Nocturnal enuresis
. Episodes of near retention
Assessment Of A Patient With Prostatism/LUTS
General examination : to exclude renal insufficiency-raised BP, anemia
Local examination : palpable mass: distended bladder; hydronephrotic kidney.