Prostatitis! No cure but here is how to control it!
Prostate gland of male reproductive system is about the size of walnut and surrounds the urethra. Most frequently encountered diseases affecting prostate are Prostatitis, Benign prostatic hyperplasia and Prostatic cancer. Our objective of study was to evaluate the spectrum and correlation of prostatic lesions with presenting complaints of patient.
Specimens were taken through transurethral resection of prostate TURPsimple prostatectomy and radical prostatectomy. A questionnaire was made and information including name, age, ward name of hospital, laboratory number, clinical diagnosis and symptoms were noted in it.
Data was entered and analyzed through SPSS During the targeted months, 48 prostatic specimens were received with a mean age of Common presenting complains were urinary retention in 23 Frequency of prostatic Grad der Prostatitis is on the rise and measures should be taken for its early detection. Screening protocols and awareness programs need to be introduced. Screening programs should be Grad der Prostatitis on level of androgens and molecular pathogenesis.
Worldwide, diseases of Prostate gland are responsible for significant morbidity and mortality among adult males [ 1 ]. It is estimated that number of males in the U. Prostate cancer is the most common malignant tumor in men all over the world and is also the second important cause of cancer related deaths in men after lung cancer. It is estimate that about 1 man in 6 will be diagnosed with prostate cancer during his lifetime. It occurs mainly in older men and about 6 cases in 10 are diagnosed in men aged 65 or older.
The average age at the time of diagnosis is about Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2. In Pakistan, prostatic cancer was fifth commonest tumor occurring in 7. It produces and store a milky white fluid which becomes the part of semen and consists of sugars, proteins and other chemicals which help the sperm to survive in female Grad der Prostatitis tract [ 5 ].
It is a retroperitoneal organ encircling the neck of bladder and urethra and is devoid of distinct capsule. In adults, Prostatic parenchyma can be divided into four Grad der Prostatitis and anatomical zones: peripheral, central, transitional and anterior fibromuscular stroma. Most hyperplasia occurs in transitional zone while most carcinoma originates in the peripheral zone.
Most frequently Grad der Prostatitis diseases affecting prostate are Prostatitis, Benign prostatic hyperplasia and Prostatic cancer [ 1 ]. Inflammation of prostate gland is called Prostatitis, it is characterized by urinary frequency, dysuria, body aches and sometimes fever.
Prostatitis may be infective and non-infective Grad der Prostatitis 5 ]. In some males, prostate enlargement occurs with the increase in age [ 6 ]. Benign Prostatic Hyperplasia or Nodular Hyperplasia is the non-malignant adenomatous overgrowth of prostate gland [ 7 ]. It is characterized by hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large discrete nodules in peri-urethral Grad der Prostatitis of prostate [ 6 ].
It often presents with lower urinary tract symptoms [ 8 ]. Symptoms include weak stream, hesitancy, frequency, urgency, nocturia, incomplete emptying, terminal dribbling, overflow or urge incontinence and Grad der Prostatitis urinary retention [ 7 ].
Adenocarcinoma is its Grad der Prostatitis common histological variant [ 1 ]. Most important risk factors for developing Prostate carcinoma are Family history, increasing age, lack of exercise and high calcium intake [ 9 ]. In most cases, it Grad der Prostatitis asymptomatic and develops slowly.
However, it may present with pain, difficulty in urinating and problems during sexual intercourse [ 5 ]. Our main goal of study was to evaluate the spectrum of prostatic disorders and assess the relationship of patient presenting complains with prostatic disorders. It was a cross-sectional study conducted during the period of 1 st January to December in Pathology department of Dow Medical College, which collects specimens from both Civil Hospital and Lyari General Hospital Karachi, Pakistan.
These are two of the largest public sector, tertiary care hospitals in Karachi. They provide subsidized healthcare to patients, majority of whom belong to low socio-economic class. Specimens examined were taken by transurethral resection of prostate TURPsimple prostatectomy, radical prostatectomy and radical cystoprostatectomy. Abnormalities such as increase in weight or size and gross characteristics such as nodular and cystic changes were noted. After cutting and processing of sections they were embedded in paraffin.
Presence of prominent nucleoli was advocated as diagnostic criterion of prostate cancer. Most of these prominent nucleoli were in areas of inflammation, basal cell hyperplasia, atrophy, or Paneth cell-like change. In addition to nucleolar prominence, multiple nucleoli and nucleolar margination have also been suggested as diagnostic criteria for prostate cancer.
Multiple nucleoli are never found in benign gland. Presence of glands in a perineural location used to be considered as a diagnostic hallmark of malignancy. Circumferential growth or intraneural invasion should be regarded as pathognomonic of cancer. Cytoplasmic features in malignancy vary from clear amphophilic to eosinophilic.
Collagenous micronodules are another recently described histological observation in Prostate cancer. These microscopic nodular aggregates of paucicellular eosinophilic fibrillar stroma are a specific, but infrequent, diagnostic clue in prostatic adenocarcinoma. Prostatic crystalloids are intraluminal, eosinophilic and Grad der Prostatitis structures of varying size and shape, which are closely associated with prostate cancer.
Presence of intraluminal acidic mucin also has been advocated as useful supportive evidence in Grad der Prostatitis diagnosis of prostate adenocarcinoma [ 10 ]. Nodularity is the hallmark Grad der Prostatitis Benign Prostatic Hyperplasia. In the usual case prostate enlarges up to gm and nodular hyperplasia of the prostate originates almost exclusively in the inner aspect of Prostate gland. On cross section, the nodules vary in color and consistency.
Grad der Prostatitis nodules that contain mostly glands, tissue is yellow pink with soft consistency and a milky white prostatic fluid oozes out of these areas. In nodules which are composed primarily of fibromuscular area, each nodule is pale gray, tough and does not exclude fluids [ 10 ]. A questionnaire was made and information including name, age, ward of hospital, laboratory number, clinical diagnosis and presenting complains were noted. Prostatic lesions were classified into benign and malignant.
They were tabulated with age and symptoms. Transurethral resection Grad der Prostatitis the prostate, commonly known as a TURP is a urological operation. It is used to treat benign prostatic hyperplasia BPH. As the name indicates, it is performed by visualizing the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This procedure is done with spinal or general anesthetic. A triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete.
Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it to treat prostate cancer. All data was entered and analyzed through SPSS Mean and standard deviation were evaluated for continuous data. Frequency and percentage were calculated for categorical data.
During the period of three years from 1st January to 31st December48 prostatic specimens were received. Mean age of presentation was Patients were commonly present with urinary retention in 23 All prostatic lesions were classified as benign and malignant. Out of 48 patients, 42 were of Benign Prostatic Hyperplasia and 6 were of adenocarcinoma. Total 28 patients were in this age group, out of which 23 Most common presenting symptoms of Benign Prostatic Hyperplasia were urinary retention 21 Patients of Prostatic carcinoma were mostly present with urinary retention 2 8.
Two important histopathological prostatic lesions are benign prostatic hyperplasia and Prostatic carcinoma. These lesions cause enlargement of prostate gland, constricting the urethra and thus causing Grad der Prostatitis urinary symptoms.
In our study, mean age of patients Grad der Prostatitis These findings were similar with studies conducted in Pakistan, Oman, India and Saudi Arabia [ 611 - 13 ]. Most common prostatic lesion found in our study was Benign prostatic hyperplasia 42 In our study. It was found that frequency of hyperplasia increases Grad der Prostatitis age from fifth decade to seventh decade, this reflects that Grad der Prostatitis may be a normal aging process.
It is believed Grad der Prostatitis the main component of the hyperplastic process is impaired cell death due to which there is an overall reduction in the rate of cell death, resulting in the accumulation of senescent cells in the prostate. It is believed that DHT- induced growth factors cause increase proliferation of stromal cells and decreasing the death of epithelial cells. Microscopically hallmark of BPH is nodularity. Early nodules are composed of stromal cells and later predominantly epithelial nodules arise.
From their origin, nodular enlargement encroaches into the lateral walls of urethra [ 1015 - 17 ]. Commonest complains of patients of Benign prostatic hyperplasia were urinary retention 21 It may be due to the fact that increase Grad der Prostatitis of gland and smooth muscle mediated obstruction of prostate cause urethral obstruction. Increased resistance to urinary flow leads to bladder hypertrophy and distention, accompanied by urine retention. Inability to empty the bladder completely creates a reservoir of residual urine that is a common source of infection, due to which urine frequency, nocturia, difficulty in starting Grad der Prostatitis stopping of stream of urine ,overflow dribbling and Grad der Prostatitis occurs [ 1018 ].
Bladder outflow obstruction may lead to Urinary Tract Infections, hydronephrosis and pyenephrosis. After Benign Prostatic Hyperplasia, Prostatic Adenocarcinoma was found to be the commonest lesion Same findings were also reported in a study conducted in Faisalabad, Pakistan Further, in contrary to our study, study in India showed peak age of incidence in the Grad der Prostatitis decade of life [ 12 ].