Prostate

% of central zone

25

avg size and volume of normal prostate

4x3x2 and up to 30cc

% of transition zone

5

% of peripheral zone

70

More than what% of prostate cancers diagnosed in men over age 65

70

indications for a prostate scan

Abnormal prostate specific antigen (PSA) lab test (higer value = more risk of malignancy, monitored when levels exceed 4 ng/mL) Dysuria, nocturia or urinary hesitancy/retention Ejaculatory or perineal pain Hematospermia Used in conjunction with digital rectal exam Guidance for prostate biopsy

define Prostatitis

Acute inflammation of the prostate gland, usually occuring in the peripheral zone May be acute or chronic

which race has a greater risk of prostate cancer

African American

Most common cause of prostate enlargement is...

Benign Prostatic Hyperplasia (BPH)

clinical findings of prostate cancer

Elevated PSA Abnormal rectal exam Bladder outlet obstruction Weight loss Bone pain

acute prostatitis clinical findings

Fever, low back pain, perineal pain Bacteruria Digital exam reveals hard, swollen, tender gland

sono findings of BPH

Gland appears more rounded instead of cresent-shaped Transition portion of gland enlarges AP Increasing heterogeneity of gland Distorted bladder wall Will see defect after transurethral resection of the prostate (TURP)

sono findings acute prostatitis

May be normal Hyperechogenicity of peripheral zone Hypervascularity Possible abscess

most prostate cancers occurs in which zone

Most cancers occur in peripheral zone of prostate typically by the apex *know this*

Chronic prostatitis Clinical Findings

Penis, scrotum and perineal discomfort Issues voiding Relapsing urinary tract infections Infertility

Most common cancer in American men

Prostate Cancer

age range for BPH

Rarely seen in men under 30 years old, affects up to 50% of men by age 60

sono findings of chronic prostatitis

Scattered focal masses Calcifications Capsular thickening and/or irregularity

the prostate secreate what type of fluid? what does it do?

Secretes alkaline fluid that provides a mode of transport for sperm

where do the seminal vesicles arise from

Seminal vesicles arise obliquely from superior prostate, posteroinferior to bladder

sono findings of prostate cancer

Small, hypoechoic nodules in peripheral zone Most malignant masses occur close to apex and in close contact with capsule Asymmetric enlargement of prostate Hypervascularity with low RI Overdistended bladder Bladder wall irregularity

Sector displayed inverted what does trans and sag show?

Transverse: Right lobe on left side of screen Sagittal: Base on left side of screen

clincial findings of BPH

Urinary symptoms (hesitancy, retention, nocturia) due to constriction of prostatic urethra Rectal exam reveals soft, boggy, nodular prostate

prostate is inferior to

bladder

the anterior 1/3 is

fibromuscular stroma

the posterior 2/3 is

glandular tissue

% of periurethral zone

less than 1

the glandular tissue of the prostate produces what

prostate specific antigen

prostate surrounds

proximal urethra

Prostate is anterior to

rectum

the more caudal portion is what

the apex

more cephalic portion is what

the base

Seminal vesicles produce what?

the majority of the fluid volume of ejaculate

BPH nodules from within which zone

transition zone

anomalies of the prostate structure are associated with what?

unilateral renal agenesis

glandular tissue is divided into

zones