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Prostate

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all about prostate n BPH

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Prostate

  1. 1. BY, SHARMEEN SHAKOOR
  2. 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
  3. 3.  The prostate gland is divided into :  Peripheral zone.  Central zone.  Transition zone
  4. 4.  Glandular cells  Smooth muscle cells  Stromal cells  The prostate gland also contains an enzyme5 alpha-reductase type-2 that convertstestosterone to Dihydrotestosterone (morepotent)
  5. 5.  Enlarged prostate i.e Benign prostatic hyperplasia  Prostate cancer  Prostatitis
  6. 6.  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.
  7. 7.  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.
  8. 8. Symptoms related to urine storage in the bladder are the following:  Frequent micturition.  Nocturia (nocturnal urination).  Urinary urgency.  Urge incontinence
  9. 9. 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.
  10. 10.  history  Physical examination : • digital rectum test • palpate  PrUrinalysis  Uroflowmetry  Cystoscopy  Ultrasound  prostate Specific Antigen (PSA) Test
  11. 11.  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? 
  12. 12.  Prostatitis  Bladder obstruction  Bladder cancer  Neurogenic bladder
  13. 13.  Watching waiting  Home plan  Medications :  surgery
  14. 14.  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
  15. 15.  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
  16. 16. - Age - Genetics - Faulty BRCA2 gene linked to aggressive. - Diet - Medication - Obesity - STDs - Agent orange - Enzyme PRSS3 linked to aggressive
  17. 17.  Stage I  Stage II  Stage III  Stage IV
  18. 18. 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)
  19. 19.  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)
  20. 20.  Metastasis  Incontinence  Erectile dysfunction  Metabolic factors
  21. 21.  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.
  22. 22.  PSA test blood test  Prostate biopsy  Transrectal ultrasound  Bone scan  CT  MRI  ProstaScintTM scan
  23. 23.  Prostatitis  BPH
  24. 24.  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
  25. 25.  Prostatitis is inflammation caused by an infection of the prostate.  Treated with antibiotics

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