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Urology General > Andrology > Flashcards

Andrology Flashcards

1
Q

how common is varicocele?

A

15% in general population

30% in infertile men

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2
Q

what is the classification for varicocele?

A 
Hudson
grade 3 visible
2 palpable on standing
1 palpable with valsalva
0 subclinical
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3
Q

why does OAT occur in varicocele?

A

higher intrascrotal temp
ROS
reflux

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4
Q

evidence for varicocelectomy for subfertility

A

pregnancy rate
Ficarra: 20 -> 36%
Marmar: odds 2.6

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5
Q

what are the techniques for varicocelectomy?

A

high retro Palomo
inguinal Ivanissevich
subinguinal Marmar
Lap

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6
Q

Hydrocele and failure rate of microscopic subinguinal varicocelectomy

A

hydrocele 0%

failure 1.4%

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7
Q

types of priapism

A

ischemic
non-ischemic
stuttering

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8
Q

name the corporoglandular shunts for priapism

A

percutaneous: Winter, Ebbehoj, T-shunt
open: Al-Ghorab, Burnett

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9
Q

name the proximal shunts for priapism

A

Quackels/Sacher: corporospongiosal
Grayhack: corporosaphenous
Barry: dorsal vein shunt (corporo-)

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10
Q

what blade is used for T-shunt?

what dilator size is used for tunnelling?

A 
#10
Fr 20 - 24
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11
Q

what are the stages of spermatogenesis?

A 
neonatal gonocyte, adult dark spermatogonia, pale
meiosis 1: primary spermatocyte
meiosis 2: secondary spermatocyte
spermatid
spermatozoa
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12
Q

what is retrograde ejaculation

A

failure bladder neck contraction

propulsion of sperm back

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13
Q

what is Liverpool solution?

A

NaCl NaHCO3

alkalinize post-orgasmic urine

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14
Q

what are the methods of sperm retrieval for anejaculation?

A

Above T10/intact bulbocavernosus reflex: penile stimulation

Below T10: Seager electro-ejaculator to stimulate perirectal and periprostatic sympathetic nerves

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15
Q

Most common mode of inheritance for Kallmann syndrome

A

X-linked recessive

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16
Q

How common is =
Obstructive azoospermia
Obstruction at epididymis, ejaculatory duct?

A

20%
epididymis 50%
ejaculatory duct < 3%

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17
Q

CTFR gene

Ch =?

A

Ch 7

18
Q 
WHO 2010 lower limit wrt sperm parameters:
volume
total
sperm conc
total motility
vitality
morphology
A 
1.5ml
39
15
40
58
4
19
Q

what is Cap-score?

A

Ganglioside localization pattern (apical = good)

calcium influx and capacitation

20
Q

what is Johnsen score?

A

1 - 10
1 = fibrosis
10 = complete spermatogensis

21
Q

Risks of chromosomal abnormalities and congenital malformation associated with ART?

A

3X

OR 1.29

22
Q

what ART technique will you choose for:
Irreversible OA
Reversible OA
NOA

A

PESA
MESA / ART
mTESe

23
Q

what is mTESE

A

microdissection
seminiferous tubules
identify enlarged tubules

24
Q

Failure rate of various vasal occlusion techniques = ?

A

Mucosal cautery: 0.28%
Suture ligation: 0.51%
Marie Stopes: 0.64%

25
Q

Post-vasectomy semen analysis Mx

A

One azoopsermic

after 12wk , 20 eja

26
Q

Special clearance for post-vasectomy

A

One SA
< 100,000/ml, immotile
12 wk

27
Q

Factors related to successful vasectomy reversal

A 
interval
expertise
length
vasal fluid
sperma granuloma
young female partner
28
Q

Pregnancy rate post-vasectomy reversal (VVSG)

A

< 3: 76%
3 - 8: 53%
9 - 14: 44%
> 15: 30%

29
Q

Neurology wrt erection:
somatosensory
somatomotor
parasympathetic

A

pudendal S2 - 4
Onuf S2 - 4
cavernosal nerve

30
Q

serum testosterone components

A

free + alb-bound + SHBG-bound

31
Q

T 1/2
Viagra
Cialis

A

4h

18h

32
Q

how common is hypogonadism

A

18% in > 70y

33
Q

Absolute and relative contraindications of T replacement

A

2 + 5

34
Q

regarding ejaculation and their spinal levels:
secretory centre
mechanical centre

A

T10 - L2

S2 - 4

35
Q

what is Dapoxetine?

efficacy

A

Priligy
SSRI
3 fold increase in IELT

36
Q

Peyronie’s disease

___ over-expression

A

TGF-B1

37
Q

Peyronie:

most common location

A

dorsal 78%

38
Q

Peyronie: natural history

A

48% worse
40% stable
12% better

39
Q

Peyronie: postulated mechanisms:
Colchicine
vit E
POTABA

A

anti-inflam/stimulate collagenase/down-reg TGF-a
antioxidant
potassium para-aminobenzoate, enhanced O2 uptake

40
Q

Peyronie: efficacy of LiESWT

A

pain relief only

41
Q

what is Nesbit procedure?

A

plication

excision of elliptical portion of TA

Urology General (13 decks)

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