Male GU Disorders

Question 1

BPH

Answer 1

not malignant, common in men 60+, male estrogen levels increase and leads to increased sensitivity of prostate gland

Question 2

Risk factors for BPH

Answer 2

obesity, smoking, heavy alcohol use, CV disease, HTN, diabetes, high fat diet

Question 3

Symptoms of BPH

Answer 3

urinary frequency, hesitancy, urgency, nocturia, decreased stream, dribbling, urinary retention, dilation of ureters and kidneys, UTIs

Question 4

Diagnosis of BPH

Answer 4

DRE, PSA, Measurement of post-void residual, Urinalysis, BUN, Creatinine, GFR

Question 5

Treatment of BPH

Answer 5

catheterization if unable to void (urologist), may require subrapubic catheter, failure to treat may require ARF

Question 6

Meds for BPH

Answer 6

tamsulosin, terazosin, doxasozin, finasteride, tadalafil (side effects are ED, gynecomastia, hypotension)

Question 7

TURP

Answer 7

transurethral resection of prostate, most common surgical treatment via the urethra

inner portion of prostate removed, performed w/ US

Question 8

other surgical treatments for BPH

Answer 8

transurethral needle ablation and prostatectomy

Question 9

Post op care for TURP

Answer 9

CBI = Continuous Bladder Irrigation
3-way catheter w/ 30-45ml balloon
adjust NS irrigation to maintain colorless (or light
pink) drainage
24 hours
 I&O !!!!
Pt. will feel urge to void continuously
due to pressure of catheter
Bladder spasms may occur
administer antispasmodic medications
After catheter removal
clots, dribbling, & leakage normal
Increase fluid intake to 2000+ ml/day
be careful of contraindications
may not be able to handle this amount (volume overload)

Question 10

Prostate cancer

Answer 10

most common male cancer, 1/6 60% occur in men 65+, 2nd most common cancer death in men, 98% will survive 5 yrs

Question 11

Risk factors for bladder cancer

Answer 11

Age 50+, african american men, family history, diet high in red meat and dairy

Question 12

Symptoms of bladder cancer

Answer 12

 may include signs of urinary obstruction
 Dysuria, frequency, decreased stream, retention
 Hematuria
 sexual dysfunction

Question 13

Diagnostics of prostate cancer

Answer 13

DRE
 PSA
 Ultrasound guided biopsy
 MRI, CT Scan, Bone Scan to detect metastasis

Question 14

Treatment of prostate cancer

Answer 14

1. Radical prostatectomy = 1st line treatment
    2. Radiation - may be curative but side effects are difficult
   »» inflammation of bladder, bowel, & rectum
   »» painful urination, diarrhea, rectal discomfort
    3. Hormonal Treatments
    leuprolide (Lupron) IM or SC
    chemical castration
    4. Other treatments:
    Therapeutic vaccine for men with metastatic prostate