3. Men's Health Flashcards
What is phimosis?
Prepuce cannot be fully retracted in adult
What can phimosis lead to?
Poor hygiene, increased STDs Pain on intercourse Balanitis (inflamed glans) Posthitis (inflamed foreskin) Paraphimosis Urinary retention Penile cancer
What is paraphimosis?
Painful constriction of the glans penis by the retracted prepuce proximal to the corona
What are the commonest causes of paraphimosis?
Phimosis
Catheterisation
Penile cancer
What kind of cancer is penile cancer?
Squamous cell carcinoma
What are the key indications for circumcision in children?
Religious
Recurrent balanitis/UTIs
What are the key indications for circumcision in adults?
Recurrent balanitis Phimosis Recurrent paraphimosis Balanitis xerotica obliterans Penile cancer
What can cause acute scrotal pain?
Testicular torsion Epididymitis/orchitis/epididymo-orchitis (UTI, STI, mumps) Torsion of hydatid of morgagni Trauma Ureteric calculi
What is the history in testicular torsion?
Usually younger patient
Sudden onset
Unilateral pain, may be nauseated/vomit
What is the history in epididymo-orchitis?
Gradual onset
Usually unilateral
Recent history of UTI, unprotected intercourse, catheter
What are the investigations for epididymo-orchitis?
Bloods - FBC, U and E, cultures if septic
Urine - MSU
Radiology - USS if suspect abscess
What is the treatment for epididymo-orchitis?
Antibiotics
What is the history in testicular cancer?
Usually painless
Germ cell tumours <45 years
What is the history for hydrocoele?
Slow/sudden onset
Uni/bilateral scrotal swelling
What is the treatment for testicular tumour?
Inguinal orchidectomy
What is the treatment for epididymal cyst?
Reassure
Excise if large
What is the treatment for adult hydrocoele?
If normal testis on ultrasound, reassure, surgical removal if large or symptomatic
What is the treatment for varicocoele?
Reassure
Radiological embolisation if symptomatic, infertility, growth of testis affected
What are the causes of urinary retention?
Prostatic enlargement Phimosis/urethral strictures/meatal stenosis Constipation UTI Drugs Over-distension Following surgery Neurological
What are the treatments for enlarged prostate?
Alpha blockers - act by relaxing smooth muscle within prostate and bladder neck
5alpha-reductase inhibitors - act by shrinking the prostate by means of androgen deprivation
What is the standard surgical treatment for enlarged prostate?
Transurethral resection of prostate (TURP)