Genitourinary #4 Flashcards
What is a varicocele?
Cystic testicular mass of varicose veins
Varicocele is the MC
surgically correctable cause of male infertility
Why does a varicocele cause infertility in men (what is the pathophysiology of it)?
Increased temperature from increased venous blood flow inhibits spermatogenesis
Physical exam findings of a varicocele?
-Soft scrotal mass with a “bag of worms” feel superior to the testicle
-Dilation worsens when patient is upright or with Valsalva
-Less apparent when supine or with testicular elevation
Diagnostic of choice for varicocele
US
What is seen on US with a varicocele?
Dilation of the pampiniform plexus > 2 mm
A right-sided varicocele is associated with ______ whereas a left-sided varicocele is associated with _____
right: retroperitoneal or abdominal malignancy
left: in older man, due to renal cell carcinoma
Symptoms of a urethral stricture
Chronic obstructive voiding symptoms (weak urinary stream, recurrent UTI’s, incomplete bladder emptying, dysuria)
What are some diagnostics that you can do to diagnose a urethral stricture?
Cystourethroscopy
Retrograde urethrogram
Voiding cystourethrogram
US urethrography
Treatment for urethral stricture
Endoscopic treatment or surgical reconstruction
True or False: Bladder carcinoma is the MC malignancy of the GU system
True
What is the MC type of bladder cancer?
Urothelial (Transitional cell) carcinoma
Risk factors for bladder carcinoma
-Smoking (MC)
-Occupational exposure to dyes, leather, and rubber (beauticians and auto workers)
-Age > 40
-Caucasian
-Male sex
-Cyclophosphamide, Pioglitazone
-Long term indwelling catheter use
MC symptom of bladder carcinoma
Painless gross hematuria (in a smoker)
What are diagnostics that should be done when a patient has irritative voiding symptoms?
-UA with microscopy to rule out benign causes (UTI, pyelonephritis)
-Imaging of GU tract: CT urography
