Ch. 39 Disorders of the Male Genitourniary System Flashcards
What is erectile dysfunction?
Inability to achieve and maintain erection sufficient to permit satisfactory sexual intercourse
What causes psychogenic erectile dysfunction?
Performance anxiety
Emotional issues with partner
Depression
What are the neurogenic causes of organic erectile dysfunction?
Stroke, spinal cord injury, surgery
What are the vascular causes of organic erectile dysfunction?
Hypertension, smoking, diabetes mellitus
What is the hormonal cause of organic erectile dysfunction?
Decreased androgen levels
What are the drug-induced causes of organic erectile dysfunction?
Antihypertensives, nicotine, alcohol, antidepressants, antipsychotics, B-blockers
What are the five types of organic erectile dysfunction?
Neurogenic, vascular, hormonal, drug-induced, aging
What are the treatments for erectile dysfunction?
Psychosexual counselling Medication Vacuum constriction devices Prosthesis Vascular surgery
What types of medications are used for erectile dysfunction?
Androgen replacement (when deficiency is confirmed) Oral Phosphodiesterase type 5 inhibitors Intracavernous
What are causes of penile inflammation/infection?
Due to trauma, irritation, infection
Candida albicans, bacteria
Often related to STIs
What are the manifestations of penile inflammation/infection?
Erythema, edema of glans and prepuce
Malodorous discharge
What is Blanitis xerotica obliterans?
Sclerosing atrophy of the foreskin in uncircumcised men: precancerous state
What is priapism?
Involuntary, prolonged, painful erection d/t impaired blood flow in corpus cavernosa resulting in failure of detumescence
What are the risk factors of priapism?
Any age
Sickle cell disease, neoplasms
What are the two kinds of priapism?
Primary
Secondary
(Hematological, neurological, renal
Medications )
What is testicular torsion?
Twisting of the spermatic cord suspending testes
What is the difference between extravaginal and intravaginal testicular torsion?
Extravaginal = involves inner and outer structures.
Intravaginal = only involves inner structures
What is cryptorchidism?
Failure of one or both testicles to move down inguinal canal into scrotal sac by 7-9 months gestation
What are the risk factors for cryptorchidism?
Prematurity, small birth weight, genetic if term-baby
What are possible complications of cryptorchidism?
Infertility, testicular torsion, malignancy (high rate), phsychological
What is the treatment for cryptorchidism?
Surgery and follow-up screening
What are the causes of prostatitis?
Spontaneous Instrumentation Secondary to: HIV Diabetes mellitus Urethral strictures
What are the four types of prostatitis?
Acute bacterial
Chronic bacterial
Chronic prostatitis/pelvic pain syndrome
Asymptomatic inflammatory prostatitis
What is the most common causative agent in acute prostatitis?
E. Coli
What are the manifestations of acute prostatitis?
Fever, malaise
Dysuria, frequency
Pelvic aching pain (radiates to rectum, perineum)
Malodorous cloudy urine
Rectal exam: swollen, tender, warm, pressure causes thick discharge.
What is benign prostatic hyperplasia?
Non-malignant enlargement of prostate due to imbalance between cell proliferation and apoptosis
What is benign prostatic hyperplasia related to?
Proliferation of prostate cells
Alpha 2 adrenergic receptors overreact
Detrusor instability & impaired bladder contractility
What does prostate enlargement cause when it compresses the urethra?
Weak stream, urgency, dysuria, nocturia, overflow incontinence
What is the result of bladder distention as a result of benign prostatic hypertrophy?
Bladder distension causes destructive changes in bladder wall
- Hydroureter, hydronephrosis, herniations, and infection
What are the treatments for benign prostatic hypertrophy?
Pharmacologic
Herbal therapies
Surgery
What are the pharmacologic treatments of benign prostatic hypertrophy?
Alpha adrenergic blockers
Alpha reductase inhibitors block androgens
What are surgeries for benign prostatic hypertrophy?
Removal of enlargement
- Transurethral prostatic resection (TUPR)
- Suprapubic, perineal
Laser vaporization, microwave, needle ablation
What is the second most frequently diagnosed cancer in men?
Prostatic cancer
What are the manifestations of prostatic cancer?
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
What are the screening/diagnostic methods for prostatic cancer?
Digital exam via rectum
Transrectal ultrasound
Prostatic specific antigen (PSA)
What are the treatments for prostatic cancer?
Surgery
- Radical Prostatectomy
Radiation
Hormonal therapy to reduce testosterone levels
