Endoscopic Diagnosis and Treatment in Prostate Pathology

Handbook of Endourology

Petrisor Aurelian Geavlete

• Publisher: Academic Press
• Year: 2016
• Print ISBN: 9780128024058
• eBook ISBN: 9780128026663
• Topic: Biological Sciences
• Subtopic: Human Anatomy & Physiology
• Index: Biological Sciences

Handbook of Endourology contains five focused, review-oriented volumes that are ideal for students and clinicians looking for a comprehensive review rather than a whole course. Each volume is easily accessible through eBook format.Topics covered review both the endourological diagnosis and treatment of prostate, urethral, urinary bladder, upper urinary tract, and renal pathology. All chapters describe the most recent techniques, review the latest results, and analyze the most modern technologies.In the past ten years, the field of endourology has expanded beyond the urinary tract to include all urologic minimally invasive surgical procedures. Recent advancements in robotic and laparoscopic bladder surgery make this one of the fastest moving fields in medicine.As current textbooks are too time-consuming for busy urologists or trainees who also need to learn other areas of urology, this collection provides quick references and over 4000 images that are appropriate for fellows as well as those teaching in the field.- Offers review content for urologists in training and "refresher content for experts in endourology- Explores new surgical techniques and technology through review-level content and extensive images of pathologies- Includes over 500 images per volume; images taken from more than 4000 endourologic procedures performed annually at the editor's hospital

Chapter 1

Endoscopic Aspects of Prostate Anatomy

Gheorghe Niţă

Petrişor Geavlete

Abstract

The prostate is an accessory gland of the male reproductive system, located in the prostatic lodge in the pelvic subperitoneal space, above the urogenital diaphragm and under the bladder. It has the shape of an anterior–posterior flattened cone, with the base directed upward (toward the bladder) and the apex directed downward. It is crossed by the initial part of the urethra (prostatic urethra). The anterior part is in contact with the pubic symphysis and the posterior one with the rectum. The side parts come in contact with the levator ani muscles. The normal weight of the prostate in an adult is 25–30 g, and the dimensions are approximately 4/3.5/2.5 cm.

Keywords

anterior lobe

central zone

lateral lobes

median lobe

peripheral zone

posterior lobe

prostate

prostatic stones

transitional zone

verumontanum

The prostate is an accessory gland of the male reproductive system, located in the prostatic lodge in the pelvic subperitoneal space, above the urogenital diaphragm and under the bladder. It has the shape of an anterior–posterior flattened cone, with the base directed upward (toward the bladder) and the apex directed downward. It is crossed by the initial part of the urethra (prostatic urethra). The anterior part is in contact with the pubic symphysis and the posterior one with the rectum. The side parts come in contact with the levator ani muscles (Yucel and Baskin, 2004). The normal weight of the prostate in an adult is 25–30 g, and the dimensions are approximately 4/3.5/2.5 cm.

From an embryological and clinical point of view, five prostatic lobes are macroscopically described (McConnell, 1998): posterior lobe, two lateral lobes, median lobe, and anterior lobe.

The anterior lobe is poorly developed, being described as a fibromuscular septum connecting the two lateral lobes.

The lateral lobes, which are located below the plane passing inferior to the ejaculatory ducts, have their origin in the posterolateral buds and can develop symmetrically or not (Fig. 1.1). The posterior lobe represents the peripheral part of the prostate and can be felt during a rectal exam. The median lobe is located toward the bladder neck, and its lower limit reaches the plane that passes through the ejaculatory ducts (Fig. 1.2).

Figure 1.1 Lateral prostatic lobes.
(a) Symmetric, (b) asymmetric.

Figure 1.2 Endoscopic aspect of the median lobe.

McNeal divides the prostate into three zones: peripheral, central, and transitional (McNeal, 1981). Approximately 75% of the entire glandular tissue is located posteriorly in the peripheral zone (McNeal, 1978). Most prostate cancers develop from this region. The central zone is located around the ejaculatory ducts. The transitional zone is usually the smallest. Two distinct lobes are described, on each side of the urethra. The transitional zone represents 5% of the prostatic volume in males under 30 years of age and is considered to be at the origin of benign prostatic hyperplasia. It usually contains a small batch of tissue with canaliculi located near the prostatic urethra (close to the internal sphi...

Table of contents

• Cover
• Title page
• Table of Contents
• Copyright
• Contributors
• Preface
• Acknowledgments
• Chapter 1: Endoscopic Aspects of Prostate Anatomy
• Chapter 2: Endoscopic Electroresection of Benign Prostatic Adenoma (TURP)
• Chapter 3: Bipolar Electroresection of Prostate Adenomas
• Chapter 4: Electrovaporization of Prostate Adenoma
• Chapter 5: Endoscopic Incision of the Prostate (TUIP)
• Chapter 6: Laser Treatment for Benign Prostatic Hyperplasia
• Chapter 7: Enucleation of Benign Prostatic Hyperplasia
• Chapter 8: Microwave Thermotherapy in the Treatment of Prostatic Adenomas (TUMT)
• Chapter 9: Radiofrequency Ablation in the Treatment of Benign Prostatic Hyperplasia (TUNA)
• Chapter 10: Transurethral Balloon Dilation of the Prostate
• Chapter 11: Prostatic Stents
• Chapter 12: Minimally Invasive Treatment Algorithm for Benign Prostatic Hyperplasia
• Chapter 13: The Place of Endoscopy in the Modern Treatment of Prostate Cancer
• Chapter 14: Endoscopic Treatment of Prostatic Abscesses
• Chapter 15: Endoscopic Treatment of Prostatic Lithiasis
• Subject Index