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Effects of benign prostatic hyperplasia It is important to realise that the relationship between anatom - ical prostatic enlargement, LUTS and urodynamic evidence of BOO is complex ( Figure 84.2 ). Summary box 84.2 Consequences of BPH /uni25CF /uni25CF /uni25C...

Examination of urine The urine is examined for glucose, leukocyte esterase and blood; a midstream specimen should be sent for bacteriological examination and cytological examination may be carried out if carcinoma in situ is thought possible.

FURTHER READING Mundy AR, Fitzpatrick J, Neal DE, George NJ (eds). The scientific basis of urology , 3rd edn. London: Informa Healthcare, 2010. Partin AW , Peters CA, Kavoussi LR, Dmochowksi RR, Wein AJ. Campbell–Walsh–Wein urology , 12th edn. Philadelphia, PA...

Flow rate measurement For this to be meaningful, two or three voids should be recorded using a special flow meter, usually found in urology outpatient clinics; the voided volume should be in excess of 150–200 /uni00A0 mL. A typical history and a flow rate <10 /u...

General blood tests These are normal in early disease but, in metastatic disease, there may be leukoerythroblastic anaemia secondary to extensive marrow invasion, or anaemia may be secondary to renal failure. There may be thrombocytopenia and evidence of disse...

General complications Death occurs in about 0.2–0.3% of men undergoing elective prostatectomy . In very elderly men, in men with prostate cancer admitted as an emer gency with acute or chronic retention or in those with very large prostates, the 30-day death ...

Histological appearances The prostate is a glandular structure consisting of ducts and acini; thus, the histological pattern is one of an adenocarci - noma. The prostatic glands are surrounded by a layer of myoepithelial cells. The first change associated wit...

Introduction No content extracted automatically.

Learning objectives To understand: The relationship of anatomical structure and biochemical • function to the development and treatment of benign and malignant disease of the prostate The terminology used to describe lower urinary tract • symptoms and to k...

Liver function tests These will be abnormal if there is extensive metastatic invasion of the liver. Alkaline phosphatase may be raised from either hepatic involvement or secondaries in the bone. These can be distinguished by measurement of isoenzymes or gam...

Lower urinary tract symptoms In both sexes, non-specific symptoms of bladder dysfunction become more common with age, probably owing to impairment of smooth muscle function and neurovesical coordination. Not all symptoms of disturbed voiding in ageing men sho...

MANAGEMENT OF MEN WITH e

Methods of performing prostatectomy The prostate can be approached (1) transurethrally (TURP); (2) retropubically (RPP); (3) through the bladder (transvesically; TVP); or (4) from the perineum ( Figure 84.11 ). Transurethral prostate surgery Transurethral rese...

Multiparametric magnetic resonance imaging mpMRI is an investigation to diagnose an early prostate cancer that might reduce overdiagnosis of insignificant pros - tate cancer. Here dynamic contrast is given and should have four sequences: T1-weighted imaging, T...

PROSTATIC CALCULI Prostatic calculi are of two varieties: endogenous, which are common, and exogenous, which are comparatively rare. An exogenous prostatic calculus is a urinary (commonly ureteric) calculus that becomes arrested in the prostatic urethra. Endo...

PROSTATITIS In both acute and chronic prostatitis, the seminal vesicles and posterior urethra are usually also involved. Aetiology Acute prostatitis is common, but underdiagnosed. The usual organism responsible is Escherichia coli , but Staphylococcus aureus S...

Pathology BPH a ff ects both glandular epithelium and connective tissue stroma to variable degrees. BPH typically a ff ects the submucous group of glands in the transitional zone, forming a nodular enlargement. Eventually , this overgrowth compresses the periphe...

Positron emission tomography scan In prostate cancer gallium-labelled prostate-specific membrane antigen (PSMA) has been increasingly used in positron emission tomography (PET) scans. It is sensitive in detecting lymph node metastasis and may be superior to MRI...