16. Male Reproductive System

Question 1

What are the guidelines regarding PSA screening?

Answer 1

Controversial: recommend having a convo bw patient and provider bout risks and benefits with a case-by-case basis.

Question 2

What imaging is used in the evaluation of a penile fracture?

Answer 2

Retrograde urethrogram

Note: indications include blood at the meatus, hematuria, dysuria, and urinary retention

Question 3

What is the gold standard test for male factor infertility? management?

Answer 3

Semen analysis - etiology of infertility is due to male factor in 25% of cases
Tx: artificial insemination and use of donor sperm

Question 4

Which drugs are a common cause of erectile dysfunction? How can pituitary tumors cause ED?

Answer 4

Anti-HTN (BB, thiazides) - ACEI, ARBs, and CCB are less likely
Spironolactone, cimetidine, and SSRIs can also cause ED.
Pit tumor –> inc prolactin/compress normal gonadotrophs –> low testosterone
Primary hypogonadism and psychogenic factors can also cause ED