disorders of male reproductive system

Question 1

priapism

Answer 1

erection 6+ hours
erections are caused by smooth muscle relaxation and increased arterial flow into the cavernosa
- mediated by nitric oxide
engorement of cavernosa compresses the venous outflow trapping blood
- 2nd most common cause: sickle cell disease

Question 2

priapism tx

Answer 2

sickle cell
- sedation and O2
other
- aspiratoin
- alpha adrenergic agents injected
- surgical shunting

Question 3

phimosis

Answer 3

forskin cannot be retracted
result of:
- chronic inflammation
- infection
- poor hygeine

Question 4

phimosis tx

Answer 4

antifungal

antibiotic

Question 5

paraphimosis

Answer 5

foreskin that has been retracted cannot be replaced to normal position
- chronic inflammation
constricting ring forms around glans of penis
- venous congestion in glans
- increased swelling and edema

Question 6

paraphimosis tx

Answer 6

reducing foreskin back over glans
- compressing the glans to reduce edema
occasionally slit or formal circumcision is needed

Question 7

Peyronie disease

Answer 7

formation of palpable, fibrous plaque on surgace of corpora cavernosa
- curvature of penis with painful incomplete erections

Question 8

Neoplasm of penis

Answer 8

squamous cell carcinoma on glans or inner surface of foreskin.

• pain
• bleeding
• urethral discharge

Question 9

tx for neoplasm of penis

Answer 9

topical chemo
radiation
partial panectomy or total

Question 10

varicocele

Answer 10

inflammation or dilation of veins in spermatic cord

- inadequate or absent valves in spermatic veins

Question 11

hydrocele

Answer 11

scrotal swelling due to collection of fluid with the tunica vaginalis

• common between abdominal cavity and scrotum through processus vaginalis
• congential
• secondary to injury, radiation, infection of epidiymis, testicular neoplasms.

Question 12

spermatocele

Answer 12

painless diverticulum (sac) of the epididymis located between head of epididymis and the testis
- tx: excise

Question 13

hydrocele tx

Answer 13

surgical procedure to drain fluid

aspiration

Question 14

hypogonadism

Answer 14

androgen deficiency in aging male

tx: testosterone injection

Question 15

infertility

Answer 15

inability to conceive after 1 year of unprotected sex

Question 16

parental factors for infertility

Answer 16

unhealthy wt
smoking
stress
toxin/chemical exposure
hormone disruptors
excess alcohol
nutritional deficiency
insulin insensitivity 
physical inactivity  
some drugs

Question 17

epididymitis

Answer 17

inflammation of testis

• trauma
• reflux. of urine into vas defrens
• majority: bacterial or STI

Question 18

epididymitis s/s

Answer 18

enlarge scrotum, red and tender
pain, may radiate to inguinal area
fever
urethral discharge
cystitis
cloudy urine

Question 19

epididymitis tx

Answer 19

bed rest
scrotal support
antibiotics

Question 20

Benign prostatic hyperplasia

Answer 20

enlargement of the prostate gland
symptoms: associated with urethral compression
relationship to aging
evaluation
- rectal exam
- prostate specific antigen monitoring

Question 21

BPH s/s

Answer 21

dec. force in urine stream
hesitancy or difficulty initiating urination
interruption of stream
infection with residual urine

Question 22

BPH tx

Answer 22

alpha blockers
5a-reductase inhibitors
microwave therapy
needle ablation
surgery (TURP): transurethral resection of prostate

Question 23

prostate cancer

Answer 23

adenocarcinomas and demonstrate peripheral zone growth
asymptomatic till advanced stages
s/s similar to BPH

Question 24

prostate cancer tx

Answer 24

surgery
radiation
cryotherapy

Question 25

prostatitis

Answer 25

inflammation of prostate
bacterial causes
other causes

Question 26

prostatitis s/s

Answer 26

fever, chills
low back pain
voiding
- frequency
- urgency
- dysuria 
rectal exam
- tender, swollen prostate

Question 27

prostatitis tx

Answer 27

antibiotics
oral anti-inflammatories
a-blockers
prostatic massage
sitz baths