Genitourinary Disease Flashcards
hypospadias
penile malformation
- opening along ventral
- UTI
epispadias
penile malformation
- opening along dorsal aspect
- UT obstruction
- urinary incontinence
squamous cell carcinoma- premalignant lesions
penile lesion
-solitary white/red plaque
-epi dysplasia
~10% gets invasive
Bowen Disease?
penile squamous cell carcinoma in-situ
squamous cell carcinoma
penile lesion
- rare among circumcised men early on
- crusted papule w/ ulceration/irregular margins
- metastases: rare
survival: 66% for localized; 27% with metastases in inguinal lymph nodes
first human malignancy associated with environmental influences?
squamous cell carcinoma of the scrotum
scrotum neoplasms are rare but more disorders involve what?
the testes
-scrotum can have inflammatory processes/fungal infections/systemic dermatoses
cryptorchidism
testes disorder
- incomplete decent from abdomen to scrotum
- 1% of 1 yr olds
- uni or bilateral= STERILITY
- 3-5x risk of testicular cancer
-orchiopexy reduces risk of sterility and cancer (surgery to bring down)
epididymitis and orchitis
testis inflammation
- epi most common
- swelling/tender
- UTI
- associated with STDs
- mumps complications (~20%)
torsion of testes
vascular disturbances
- twisting of spermatic cord
- venous obstruction–> vascular engorgement
- adolescences, sudden onset of pain
- UROLOGIC EMERGENCY: infarction will occur
testicular tumors- general info
- 6 in 100,000
- incidences 15-34 yrs
- most common cause of painLESS testicular enlargment
testicular tumors- heterogenous group of tumors (where)
-germ cells: 95%= malignant
s
testicular tumors- heterogenous group of tumors (where)
- germ cells: 95%= malignant
- stertoli/leydig cells (sex cord stromal tumors): 5%= benign
germ cell tumors
testicular tumor
- seminomas vs non seminomatous
- greater freq in undescended testis (3-5 fold)
- only 10% have hx crytochidism
- often mixed/multiple cell type, but can be pure/single
seminomas germ cell tumor
testicular tumor
- epithelium of seminiferous tubules (less aggressive)
- stays in testis long time–> can spread to lymphatics
- responds well to chemo, radio
- ONE OF THE MOST CURABLE CANCERS
non-seminomatous germ cell tumor
testicular tumor
-spreads early via lymphatics/blood vessels (even small tumors)
-markers: alpha fetoprotein and human chorionic gonadotropin
-prognosis better with newer chemo regimes
types:
-embryonal
-choriocarcinoma- very very aggressive
germ cell prognosis
-8,000 new cases,
prostatitis
prostate inflammatory lesions
- enlarged/tender
- caused by BAC with UTIs-e. coli
- acute or chronic
- clinically silent, may have dysuria (pain peeing), frequency, low back pain, pelvic pain
–important cause of recurrent UTIs in men
nodular hyperplasia of prostate =
benign prostatic hyperlasia (BPH)
nodular hyperplasia of prostate affects where
- inner periurethral zone compressing prostatic urethra
- proliferation of stromal and glandular elements
nodular hyperplasia
- common= 20% men affected at age 40, 90% at age 70
- clinical symptoms= hesitancy, urgency, nocturia, poor urinary stream
- chronic obstruction comes before recurrent UTI
- etiology= no idea- maybe hormonal= local increase of ANDROGENS
nodular hyperplasia tx
- medical managment= drugs
- surgical (TURP)
adenocarcinoma
carcinoma of prostate
- most common cancer of men over 50= 25% cancer, only 9% die
- can be clinically “latent”= 50% men over age 80
- metastasis: lymph nodes/bone
adenocarcinoma cause and location
carcinoma of prostate
- unknown cause: may be androgens, genes, environment
- outer (peripheral) glands, palpable by digital rectal exam
- -more malignant
adenocarcinoma marker
carcinoma of prostate
- elevated prostate specific antigen (PSA)
- good for diagnosis and management but elevation can be due to other cancer or non neoplastic conditions
adenocarcinoma tx and prognosis
carcinoma of prostate
-surgery, radiation, hormonal manipulation
- depends on anatomic extent
- -10 yrs of 10-40% for disseminated disease (traveled)
adenocarcinoma
carcinoma of prostate
- most common cancer of men over 50= 25% cancer, only 9% die
- can be clinically “latent”= 50% men over age 80
- metastasis: lymph nodes/bone (patchy bone in mandible)
adenocarcinoma cause and location
carcinoma of prostate
- unknown cause: may be androgens, genes, environment
- outer (peripheral) glands, palpable by digital rectal exam
- -more malignant
- seen radiographically as neoplastic glands
urothelial carcinoma
urinary bladder neoplasm
- majority (90%)
- men 50-80 yrs
- painless hematuria
- tumors shed in urine= detect by cytology
–can be papillary or flat
urothelial carcinoma risk factors
urinary bladder neoplasm
- cirgarette smoking
- chronic cystitis
- infection w/ schistosomia
- exposure to carcinogens
urothelial carcinoma tx and prognosis
urinary bladder neoplasm
-transurethral resection, immunotherapy, radical cystectomy
-depends on tumor grade and stage= atypia and invasion
STDs- most common
- genital herpes, genital HPV
- 10 leading infectious disease in US requiring CDC reporting: 5 are STDs
syphilis (lues)
- chronic infection by spirochete Treponemia pallidum
- > 14,000
- 30x more in AA than whites
- transmitted: direct contact with cutaneous/mucosal lesions during early (primary or secondary) stage, highly infectious
- rapidly disseminate to distant sites by blood/lymphatics
syphilis primary stage
chancre
syphilis secondary stage
- palmar rash
- lymphadenopathy
- condyloma latum
syphilis tertiary stage
- neurosyphilis: meningovascular, tabes dorsalis, general paresis
- aortitis: aneurysms, aortic regurgitation
- gummas: hepar lobatium, skin, bone, others
syphilis primary stage
-chancre (painless ulcer) at site of inoculation 9-90 days after initial infection (genitals, oral)
- antibody production
- resolves spontaneously in 4-6 WEEKS
- untreated: ~25% pts develop secondary
syphilis secondary stage
- palmar rash (maculopapular-palms/soles of feet)
- lymphadenopathy (and mucocutaneous lesions)
- condyloma latum (and mucous patches-on mucosa)
- occurs within 2 MONTHS following resolution of primary
- resolves spontaneously over SEVERAL WEEKS, enters latent phase
- untreated: close to 1/3 develop tertiary over 5-20 YEARS
syphilis tertiary stage
- neurosyphilis: meningovascular, tabes dorsalis, general paresis (10%, brain, meninges, spinal cord)
- aortitis: aneurysms, aortic regurgitation (80%, cardiovascular)
- gummas: hepar lobatium, skin, bone, upper airway, mouth (focal granulomatoys lesions)
- develops after later period of 5+ YEARS
- pts less likely to be infectious
congenital syphilis
- maternal transmission across placenta
1. stillbirth
2. infantile syphilis= clinical manifestations similar to secondary
3. late congenital syphilis= (untreated, >2yrs duration) - –hutchinson triad: teeth, intestitial keratitis, 8th cranial n deafness
- convex shines
syphilis diagnosis
- bacteria within primary or secondary lesion
- screening tests: RPR (rapid plasma reagin) and VDRL (venereal disease research laboratory): often neg early, ~15% false positive
- specific tests: FTA (fluorescent treponemal antibiody): pos later in disease, remain pos indefinitely, even after tx
–treated with antibiotics (penicillin)
