ANATOMY AND PHYSIOLOGY

The prostate gland is

located under the
urinary bladder, in
front of the rectum and
wraps around the
urethra (the tube that
carries urine through
the penis). It is
basically composed of
three different cell
types the glandular
cells, smooth muscle
cells and stromal cells.
The central area of the
prostate that wraps
around the urethra is
called the transition zone. The entire prostate gland is surrounded by a dense, fibrous capsule.
The prostate gland provides the following functions: (1) the glandular cells produce a milky
fluid, and during sex the smooth muscles contract and squeeze this fluid into the urethra. Here, it
mixes with sperm and other fluids to make semen. (2) The prostate also secretes another
substance that may have antibacterial properties. (3) The prostate gland also contains an enzyme
called 5 alpha-reductase that converts testosterone to dihydrotestosterone, another male hormone
that has a major impact on the prostate. The prostate gland undergoes many changes during the
course of a man's life. At birth, the prostate is about the size of a pea. It grows only slightly until
puberty, when it begins to enlarge rapidly, attaining normal adult size and shape, about that of a
walnut, when a man reaches his early 20s. The gland generally remains stable until about the
mid-forties, when, in most men, the prostate begins to enlarge again through a process of cell
multiplication. Hormonal changes also occur in the prostate gland; testosterone levels fall while
dihydrotestosterone remain at normal levels.
 PATHOPHYSIOLOGY

(Book based)

Etiology:

 Androgen
 Estrogen Enlargement of the Prostate
 Lifestyle
 Hereditary

Prostatic urethral becomes

compressed and narrowed

Obstruction occurs

Enlargement of bladder
smooth muscle

Formation of Trabeculation (cords

within the bladder wall) and ↑ Thickening of the bladder
release of collagen

Bladder Instability

URINARY URGENCY

URINARY INCONTINENCE

URINARY FREQUENCY

Decreased bladder contraction

 OLIGURIA
 VOIDING DIFFICULT
 DECREASED FORCE OF
URINARY STREAM
 Benign
Prostatic
Hyperplasia

As pressures in the proximal tubule

and Bowman space increase

Glomerular filtration rate (GFR) falls

Intratubular pressure decreases

to preobstruction levels

Depressed GFR is maintained by

decreases in renal blood flow

Elevation of intraluminal
ureteral pressure

Obstruction of the urinary tract

 (Client Based)

PREDISPOSING FACTORS: PRECIPITATING FACTORS:

 Diet  Age – 81y/o

 Smoking
 Alcohol use

Enlargement of the Prostate

Prostatic urethral becomes compressed

and narrowed

Obstruction occurs

Enlargement of bladder smooth muscle

 VOIDING DIFFICULT
 DECREASED FORCE OF
URINARY STREAM

Benign Prostatic Hyperplasia

Pressures in the proximal tubule

and Bowman space increase

Glomerular filtration rate (GFR) falls

 Intratubular pressure decreases
to preobstruction levels

Depressed GFR is maintained by

decreases in renal blood flow

Elevation of intraluminal
ureteral pressure

Obstruction of the urinary tract