Prostate pathophysiology

Explain the pathophysiologic mechanisms underlying the symptoms and signs of benign prostatic hyperplasia. 

FIGURE 49-1. Algorithm for selection of treatment of BPH based on symptom severity. (From Lee M. Benign prostatic hyperplasia. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 

Understand the pathophysiology underlying the clinical symptoms associated with prostate cancer. 

Pathophysiologically, accelerated breakdown of fibrin occurs secondarily to disseminated intravascular coagulation or primarily in prostatic surgery. 

Definitive evidence that dihydrotestosterone (DHT) is a potent androgen with its own important physiological and pathophysiological actions, separate from those of testosterone, was provided by two reports in 1974 of a rare inborn disorder of male phenotypic sexual differentiation caused by a deficiency in 5a-reductase, the enzyme that converts testosterone to DHT. The reduction in the conversion of testosterone to DHT by 5a-reductase, which underlies this syndrome, leads to a specific developmental defect in the formation of the male external genitalia and the prostate. Males with this genetic disorder exhibit a striking phenotype, in which the internal genitalia are normal... 

It was observed that people with low carotenoid intake or low blood levels have an increased risk of degenerative diseases. In a number of these diseases free radical damage plays a role in the pathophysiology of the disease. Earlier studies were focused mainly on p-carotene and the lycopene protective effect against prostate and lung cancer, but there is as yet no definitive proof for a causal relationship or for a beneficial antioxidant effect of carotenoids. 

Acid phosphatases are enzymes that have been studied extensively due to the fact that their dysregulation is associated with pathophysiological conditions. This characteristic has been exploited for the development of diagnostic and therapeutic methods. As an example, prostatic acid phosphatase was the first marker for metastatic prostate cancer diagnosis and the dysregulation of tartrate resistant acid phosphatase is associated with abnormal bone resorption linked to osteoporosis. 

Hiccup is a forceful, involuntary inspiration commonly experienced by fetuses, children, and adults. Its purpose is unknown, and its pathophysiology still poorly understood. Short hiccup bouts are mostly associated with gastric distention or alcohol intake. They resolve spontaneously or with simple folk remedies and do not require medical attention. In contrast, prolonged hiccup is a rare but disabling condition that can induce depression, weight loss, and sleep deprivation. A wide variety of pathological conditions can cause chronic hiccup myocardial infarction, brain tumor, renal failure, prostate cancer, and abdominal surgery are only a few of these conditions. 

Parker C, Milosevic M, Toi A, Sweet J, Panzarella T, Bristow R, Catton C, Catton P, Crook J, Gospodarowicz M, McLean M, Warde P, Hill RP (2004) Polarographic electrode study of tumor oxygenation in clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 58 750-757 Paschen W (1985) Regional qiuintitative determination of lactate in brain sections. A bioluminescent approach. J Cerebral Blood Flow Metab 5 609-612 Paschen W, Djuricic B, Mies G, Schmidt-Kastner R, Linn F (1987) Lactate and pH in the brain Association and dissociation in different pathophysiological states. J Neuro-chem 48 154-159... 

Ceri, H. Schmidt, S., Olson, M. E., Nickel, J. C. and Benediktsson, H., 1999. Specific mucosal immunity in the pathophysiology of bacterial prostatitis in a rat model. Canadian Journal of Microbiology 45, 849-855. 

---