Gu cancer

Question 1

MC cancer in young men 20-45y/o?

Answer 1

testicular cancer

Question 2

What is testicular cancer?
Arises from?

Answer 2

Arises from germ cells (gametes)
Germ cell (90+%) or non germ cell (<10%) tumour

Question 3

What do the germ cell and non germ cell tumours arise from?

Answer 3

Germ cell:
MC = Seminoma
Teratoma

Non germ cell:
Sertoli
Leydig
Sarcoma

Question 4

RF of testicular cancer?

Answer 4

Cryptorchidism (undescended testis), infertility, fHx

Question 5

Sx of testicular cancer?

Answer 5

Painless lump in testicle which does NOT transilluminate (strong light passes through to detect disease), often self found

hard and irregular lump

May show lung metastasis eg. cough - consider chest x ray

Question 6

Dx of testicular cancer?

Answer 6

Urgent doppler uss scan testes (90% diagnostic)
Tumour markers;
AFP (Raised in teratomas)
Beta hcg (both teratomas + seminomas)
+LDH raised non specifically in tumours

Question 7

Tx of testicular cancer?

Answer 7

Urgent radial orchidectomy (remove testical) + offer sperm storage always 1st line
chemo/radio therapy

Question 8

What is obstructive uropathy?

Answer 8

Blockage of urine flow, can affect one (obstructive neuropathy) or both kidneys depending on level of obstruction

Question 9

Causes of obstructive uropathy?

Answer 9

BPH (Obstructions) and stones MC

Question 10

Pathology of obstructive uropathy?

Answer 10

Obstruction = retention + increased KUB pressure, refluxing and backlogged urine renal pelvis = HYDRONEPHROSIS (dilated renal pelvis which is more infection prone)

Question 11

Sx of obstructive uropathy?

Answer 11

With obstruction!
May be aSx if only 1 kidney affected

Question 12

Tx of obstructive uropathy?

Answer 12

1. Relieve kidney pressure = catheterise urethra, urethral stent
2. Tx BPH or stones (+ infection)