1. Dr Soumar Dutta Guwahati Refinery Hospital

2. 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

4. 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

8. Cystoscopy: Indications: Haematuria Urethral stricture or H/O urethritis. Prior TURP / Open Prostatectomy IVP: Determines f(x) of kidneys Hydronephrosis / Hydroureter Diverticula of Bladder

10. Alpha- blockers : Relaxes smooth muscles -> decrease urethral resistance . Non selective : phenoxybenzamine Selective alpha 1 : Prazosine, Terazocin, Doxazocin. Selective alpha 1a : Tamsulosin and Alfuzosin Androgen suppression : Involution of Epithelial Component, decreasing Volm. Anti-androgens : Flutamide 5 Alpha Reductase Inhibitors : Finestride; Dutasteride Estrogen suppression : Atamastane

11. Surgery: Procedure: Prostatectomy Approach: Transurethral- TURP Retropubic Transvesical Perineal Complications: Haemorrhage Perforation of UB and prostatic capsule. Incontinence Urethral strictures Retrograde ejaculation and impotency Bladder neck Contractures Urethral strictures Reoperation TUR Syndrome: water intoxication --> dilution hyponatraemia.

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