GU - Male

• Enlargement of the prostate gland
• Exerts pressure on the urethra, which prevents complete emptying of the bladder.

Transurethral resection of the prostate

• TUMA - Transurethral Microwave Thermotherepy
• TUNA - Transurethral Needle Ablation
• PVP - Photoselective Vaporization of the prostate

• Transurethral Microwave Thermotherepy
• One time treatment. Catheter in the bladder allows microwaves to heat and destroy hyperplastic prostate tissue

• Transurethral Needle Ablation
• Interstitial radiofrequency needles are placed through the urethra and lateral lobes of the prostate causing heat induced coagulation necrosis.

• Photoselective Vaporization of the prostate
• Laser energy is delivered by way of a thin fiber inserted in the urethra through a cystoscopy. GreenLight laser vaporizes the prostate tissue

Transurethral resection of the prostate

• Transurethral
• Suprapubic
• Radical perineal
• Retropubic

A resectoscope is inserted through the through the urethra and bladder.

Incision if made in the abdomen and through the bladder and the gland is removed from above

Incision is made through the perineum (between scrotum and rectum)

Incision is made into the abdomen and the capsule encasing the prostate (without cutting in the bladder)

• Common over 50
• May have no symptoms until disease is advanced
• Dx Rectal exam, PSA (prostate specific antigen)normal range 0-4 ng/mL, transrectal ultrasound, bone scan, serum alkaline phosphatase.
• Medical management- brachytherapy, radical prostatectomy, hormonal depravation therapy, orchiectomy, radiation therapy

• System used for grading prostate cancer
• 2-10 used to predict how quickly the cancer will progress
• 2-4 slow growing
• 5-7 aggressive tumor 40% chance of metastasis
• 8-10 aggressive with 75% chance of metastasis