Abstract

ROBLES RODRIGUEZ, Alfredo; GARIBAY HUARTE, Tania Rocío; ACOSTA ARREGUIN, Eduardo  and  MORALES LOPEZ, Sara. The prostate: generalities and most frequent pathologies. Rev. Fac. Med. (Méx.) [online]. 2019, vol.62, n.4, pp.41-54.  Epub Oct 16, 2020. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2019.62.4.07.

The prostate is a fibromuscular and glandular organ that produces a liquid secretion that is part of the semen, it contains substances that provide nutrients and an adequate medium for the survival of the sperm. This pathology is one of the most frequent reasons for consultation in family medicine and urology, so it is important to recognize the main clinical data to be able to make differential diagnoses between prostatic hyperplasia, prostate cancer and prostatitis.

Prostatic hyperplasia (HP) is the non-malignant proliferation of epithelial cells and the stroma of the prostate gland related to the aging process of men.

The prevalence of HP increases with age; 50% of men aged between 51 and 60 have it. The mechanism by which HP can produce a bladder obstruction comprises two components: a static and a dynamic one. There are obstructive and irritative symptoms of the lower urinary tract that affect the quality of life of the patient, interfering with their daily activities and sleep patterns.

The anamnesis allows the clinicians to determine and evaluate the magnitude of these symptoms, constituting a fundamental stage of the diagnosis, hence the usefulness of using the IPSS (International Prostate Symptom Score). The rectal examination provides major data such as volume and consistency. α-Adrenergic blockers and 5α-reductase inhibitors are the two types of drugs used.

Prostate cancer (PC) is the most frequent malignant tumor in men of 50 years old and its maximum peak is after 65 years. Its incidence has increased in recent years due, in part, to the improvement in diagnostic techniques, the increase in life expectancy and other factors not so well known as environ mental exposure, diet, lifestyle and genetics. The American Cancer Society recommends an APE with or without a digital rectal exam starting at the age 50. The American Urology Association recommends it starting at the age of 40 and a biopsy in patients with PSA equal to or greater than 4 ng / ml is also suggested.

The selection of the treatment depends on the tumor staging and category of the risk, the age of the patient, life expectancy, presence or absence of symptoms and the effects of the treatment options on the quality of life.

Acute bacterial prostatitis is associated with lower urinary tract infection. The classification of patients with prostatitis depends on the bacteriological study of the lower urinary tract; prostatitis syndromes can be classified into four main groups: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS), asymptomatic inflammatory prostatitis and granulomatous prostatitis.

It represents the most frequent urological diagnosis in young males. The prevalence is 2-16% and represents 8% of urological consultations.

Keywords : Prostate; hyperplasia; cancer; prostatitis; digital rectal examination; differential diagnosis.