chap 16 - disorders of male genital organs

Question 1

male reproductive system

Answer 1

Primary sex organs
Testis
Accessory sex organs
In males, genital organs and urinary tract are in close association with one another
Share distal portion of outflow tract through prostate and penis

Question 2

most frequent and serious problems

Answer 2

Benign prostatic hypertrophy
Testicular cancer - not age associated
Relatively rare disease of young men
Infertility
Erectile dysfunction
Sexually transmitted diseases (STDs)
Most common in men
Gonorrhea
Chlamydia
Syphilis

Question 3

signs, symptoms

Answer 3

Urinary complaints
Frequency, urgency, incontinence, dysuria, nocturia
Pain in any reproductive organ or unusual discharge
Swelling or enlargement of any reproductive organs
Any sexual disorder or concern

Question 4

tests

Answer 4

Physical examination of male genital organs
Inspection of penis for exudation or ulceration from STI’s
Palpation of inguinal ring for undescended testes
Palpation of scrotum for testicular tumors
Digital rectal examination to assess size of prostate and detect nodularities
Laboratory tests
Urinalysis to test for secondary effects of obstruction
Analysis of seminal fluid
Microscopic examination of sperm motility
Microbiology to identify an STD
Prostate specific antigen (PSA) test for patients with know prostate cancer
Radiologic techniques
CT and MRI
Useful to detect tumors in prostate
Ultrasound
Used to assess for cysts and tumor in scrotum
Prostate biopsy
Involves instrument through rectum

Question 5

inflammation of the male genital organs

Answer 5

stds account for majority of inflammatory conditions in male genital organs
Three most common include:
Chlamydia
Gonorrhea
Syphilis

Question 6

diseases of the prostate

Answer 6

What is the prostate gland?
Disorders
Prostatitis
Benign prostatic hyperplasia (BPH)
Carcinoma of the prostate

Question 7

prostastitis

Answer 7

Inflammation of the prostate gland
- Acute
Spread of infection from bladder or urethra
- Chronic
Mild inflammation
Common
Causes few symptoms
Signs and symptoms
- Fever and chills
- Urethral discharge
- Dysuria
- Malaise
- Tender, enlarged prostate gland
Treatment:
- Expended course of antibiotics
- Opiate analgesics

Question 8

disorders of the prostate gland

Answer 8

Benign prostatic hyperplasia (BPH)
Enlargement of the prostate gland
Major disease among aging me
Affects 75% of men during 7th decade of life
Symptoms
Obstructs flow of urine – can lead to a UTI
Urinary hesitancy, frequent urination, nocturia
Evaluation
Digital rectal exams

Question 9

BPH

Answer 9

Hyperplasia due to dihydrotestosterone (DHT)
Testosterone converted to DHT by 5-alpha reductase
Bings to androgen receptor
Treatment
Reductase inhibitors
Surgery

Question 10

adenocarcinoma of the prostate

Answer 10

Age associated
Most common cause of death from cancer in men over age 75
2nd leading cause of cancer deaths in males

Question 11

cancer of the prostate

Answer 11

Prostatic cancer is asymptomatic until its advanced stages
- Weight loss
- Back pain
Symptoms are similar to BPH
Risk factors
- Dietary factors
- Hormones
- Chronic inflammation
- Familial factors
- Ethnicity
Diagnostic procedures
- Digital rectal exam
- Biopsy
- CT scan or ultrasonography
- PSA blood test
Outcome is highly variable
- Some die “with” prostate cancer
- Die of unrelated disease
- Others experience rapid progression and death
- Cure rates are very low

Question 12

prostate disorders

Answer 12

BPH vs prostate cancer
Identical symptoms
Occur in prostate
BPH cannot spread
PSA can be high in both

Question 13

tumor of testis

Answer 13

Rare but important; most common in men 25-45 years old
Majority germ cell tumors
Strongest risk factor is cryptorchidism
Usually malignant but can be successfully treated by surgery + chemotherapy or radiation therapy
High cure rate; >90% of patients survive
Signs and symptoms
Lump
Pain in scrotum, lower abdomen

Question 14

cryptorchidism

Answer 14

Testes does not descend normally
- Thus absence of one or both testes from scrotum
Testes normally descend to aid sperm production
Treatment
- Time
- Most will descend on their own
- Surgery
Complications
- Testicular cancer
- Fertility issues
- Testicular torsion
- Inguinal hernia

Question 15

testicular torsion

Answer 15

Twisting of spermatic cord due to rotation of testicles
- Reduces blood flow
- More common in boys 12-16
Symptoms
- Acute onset testicular pain
- Swelling of involved testis
- Medical emergency
- Death of testis within 6-12 hours

Question 16

orchitis

Answer 16

Etiology
- Mumps virus infection, sexually transmitted infections
Signs and symptoms
- Testicular pain and inflammation
- Edema
- Fever, malaise
- Urethral discharge
Diagnosis
- Recent history of mumps infection
- Presenting signs and symptoms
- Culture of urethral discharge
- Ultrasound
Treatment
- Antibiotics
- Analgesics
- Cold compresses
- Scrotal support

Question 17

scrotal abnormalities

Answer 17

Hydrocele
Excess fluid accumulates
Treated by aspiration
Varicocele
Varicose veins in spermatic cord
Usually involves left side of scrotum
One of most common causes of infertility
Treatment required if varicocele causes discomfort or impairs fertility

Question 18

erectile dysfunction

Answer 18

Difficulty developing and maintaining full erection
Frequency increases with age
Causes
Stress, emotional factors, chronic diseases
Renal failure and diabetes
Penile diseases and trauma
Low testosterone level
Treatment phosphodiesterase inhibitors
Neural control of penile erection
Parasympathetic nerves release acetylcholine and nitric oxide
NO produces vasodilation
cGMP is inactivated by PDE-5 mediated conversion to GMP

Question 19

infertility

Answer 19

Sperm deficiencies
Congenital abnormalities
Endocrine imbalances
Surgical intervention
Infection or chronic inflammation of the testes, epididymis, vas deferens