Genitourinary #5 Flashcards
What is paraphimosis?
Retracted foreskin that cannot be returned to the normal position
What are the symptoms of paraphimosis?
Severe penile pain and swelling of the penis
What is the treatment for paraphimosis?
Manual reduction. Restore original position of the foreskin. Cool compresses.
Pharm therapy for paraphimosis
granulated sugar, injection of hyaluronidase
What is the definitive management for paraphimosis?
incision or circumcision
What is phimosis?
Inability to retract the foreskin over the glans`
True or False. Paraphimosis is a urological emergency, whereas phimosis is not?
True
What is the pathophysiology of phimosis (what causes it)?
Distal scarring of the foreskin (trauma, inflammation, or infection)
Conservative treatment for phimosis
Proper hygiene
Stretching exercises (may spontaneously resolve)
4-8 weeks of topical corticosteroids can increase foreskin retractility
What is the definitive treatment for phimosis?
Circumcision
Benign prostatic hyperplasia leads to ______
bladder outlet obstruction
BPH is common in older men. Hyperplasia is part of the normal aging process and hormonally dependent on increased ________ production
dihydrotestosterone
Symptoms of BPH
Irritative symptoms: frequency, urgency, nocturia
Obstructive symptoms: hesitancy, weak force, incomplete emptying, dribbling.
What is one common medication that can worsen BPH
Pseudoephedrine
What is the prostate like on digital rectal exam in a patient with BPH?
uniformly enlarged, firm, nontender, rubbery prostate
What is the best initial therapy to relieve symptoms of BPH?
Alpha blockers (Tamsulosin, Terazosin, Doxazosin)
What is the MC adverse effect of alpha blockers?
Hypotension
True or False: Alpha blockers reduce the size of the prostate
False, they do not
5-alpha reductase inhibitors, such as _____ and ______, do reduce the size of the prostate over time
Finasterine
Dutasteride
If BPH symptoms persist with medication for 12-24 months, what is the next step in management?
TURP: removes excess prostate tissue
What is the MOA of Tamsulosin?
Smooth muscle relaxation of prostate and bladder neck leading to increased urinary outflow, obstruction relief, and decreased urethral resistance
Two common side effects of Tamsulosin/Terazosin/Doxazosin/Alfuzosin (alpha-1 blockers)
Orthostatic hypotension and dizziness