Ch. 39 Disorders of the Male Genitourniary System

Question 1

What is erectile dysfunction?

Answer 1

Inability to achieve and maintain erection sufficient to permit satisfactory sexual intercourse

Question 2

What causes psychogenic erectile dysfunction?

Answer 2

Performance anxiety
Emotional issues with partner
Depression

Question 3

What are the neurogenic causes of organic erectile dysfunction?

Answer 3

Stroke, spinal cord injury, surgery

Question 4

What are the vascular causes of organic erectile dysfunction?

Answer 4

Hypertension, smoking, diabetes mellitus

Question 5

What is the hormonal cause of organic erectile dysfunction?

Answer 5

Decreased androgen levels

Question 6

What are the drug-induced causes of organic erectile dysfunction?

Answer 6

Antihypertensives, nicotine, alcohol, antidepressants, antipsychotics, B-blockers

Question 7

What are the five types of organic erectile dysfunction?

Answer 7

Neurogenic, vascular, hormonal, drug-induced, aging

Question 8

What are the treatments for erectile dysfunction?

Answer 8

Psychosexual counselling
Medication
Vacuum constriction devices
Prosthesis
Vascular surgery

Question 9

What types of medications are used for erectile dysfunction?

Answer 9

Androgen replacement (when deficiency is confirmed)
Oral Phosphodiesterase type 5 inhibitors
Intracavernous

Question 10

What are causes of penile inflammation/infection?

Answer 10

Due to trauma, irritation, infection
Candida albicans, bacteria
Often related to STIs

Question 11

What are the manifestations of penile inflammation/infection?

Answer 11

Erythema, edema of glans and prepuce

Malodorous discharge

Question 12

What is Blanitis xerotica obliterans?

Answer 12

Sclerosing atrophy of the foreskin in uncircumcised men: precancerous state

Question 13

What is priapism?

Answer 13

Involuntary, prolonged, painful erection d/t impaired blood flow in corpus cavernosa resulting in failure of detumescence

Question 14

What are the risk factors of priapism?

Answer 14

Any age

Sickle cell disease, neoplasms

Question 15

What are the two kinds of priapism?

Answer 15

Primary
Secondary
(Hematological, neurological, renal
Medications )

Question 16

What is testicular torsion?

Answer 16

Twisting of the spermatic cord suspending testes

Question 17

What is the difference between extravaginal and intravaginal testicular torsion?

Answer 17

Extravaginal = involves inner and outer structures.

Intravaginal = only involves inner structures

Question 18

What is cryptorchidism?

Answer 18

Failure of one or both testicles to move down inguinal canal into scrotal sac by 7-9 months gestation

Question 19

What are the risk factors for cryptorchidism?

Answer 19

Prematurity, small birth weight, genetic if term-baby

Question 20

What are possible complications of cryptorchidism?

Answer 20

Infertility, testicular torsion, malignancy (high rate), phsychological

Question 21

What is the treatment for cryptorchidism?

Answer 21

Surgery and follow-up screening

Question 22

What are the causes of prostatitis?

Answer 22

Spontaneous
Instrumentation
Secondary to:
  HIV
  Diabetes mellitus
  Urethral strictures

Question 23

What are the four types of prostatitis?

Answer 23

Acute bacterial
Chronic bacterial
Chronic prostatitis/pelvic pain syndrome
Asymptomatic inflammatory prostatitis

Question 24

What is the most common causative agent in acute prostatitis?

Answer 24

E. Coli

Question 25

What are the manifestations of acute prostatitis?

Answer 25

Fever, malaise
Dysuria, frequency
Pelvic aching pain (radiates to rectum, perineum)
Malodorous cloudy urine
Rectal exam: swollen, tender, warm, pressure causes thick discharge.

Question 26

What is benign prostatic hyperplasia?

Answer 26

Non-malignant enlargement of prostate due to imbalance between cell proliferation and apoptosis

Question 27

What is benign prostatic hyperplasia related to?

Answer 27

Proliferation of prostate cells
Alpha 2 adrenergic receptors overreact
Detrusor instability & impaired bladder contractility

Question 28

What does prostate enlargement cause when it compresses the urethra?

Answer 28

Weak stream, urgency, dysuria, nocturia, overflow incontinence

Question 29

What is the result of bladder distention as a result of benign prostatic hypertrophy?

Answer 29

Bladder distension causes destructive changes in bladder wall
- Hydroureter, hydronephrosis, herniations, and infection

Question 30

What are the treatments for benign prostatic hypertrophy?

Answer 30

Pharmacologic
Herbal therapies
Surgery

Question 31

What are the pharmacologic treatments of benign prostatic hypertrophy?

Answer 31

Alpha adrenergic blockers

Alpha reductase inhibitors block androgens

Question 32

What are surgeries for benign prostatic hypertrophy?

Answer 32

Removal of enlargement
- Transurethral prostatic resection (TUPR)
- Suprapubic, perineal
Laser vaporization, microwave, needle ablation

Question 33

What is the second most frequently diagnosed cancer in men?

Answer 33

Prostatic cancer

Question 34

What are the manifestations of prostatic cancer?

Answer 34

Asymptomatic initially
Metastasis to lung reflects lymphatic spread
Migration to bladder not until later
Bone pain (vertebral, rib, pelvis) often first sign due to metastasis

Question 35

What are the screening/diagnostic methods for prostatic cancer?

Answer 35

Digital exam via rectum
Transrectal ultrasound
Prostatic specific antigen (PSA)

Question 36

What are the treatments for prostatic cancer?

Answer 36

Surgery
- Radical Prostatectomy
Radiation
Hormonal therapy to reduce testosterone levels