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Clin Med III - GU/Renal > Male GU Disorders > Flashcards

Male GU Disorders Flashcards

1
Q

Define hydrocele

A
  • Abnormal, painless collection of fluid in tunica vaginalis

- Leads to swelling of scrotum

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2
Q

Types of hydrocele

A
  • Communicating (congenital, MC in children under 12)

- Noncommunicating (acquired, imbalance in rates of fluid secretion/reabsorption)

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3
Q

Etiology of communicating hydrocele

A

Congenital patent processus vaginalis which allows peritoneal fluid to travel into tunica vaginalis

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4
Q

Etiology of noncommunicating hydrocele

A
  • Imbalance of fluid movement
  • Iatrogenic (prior surgery)
  • Acute epididymitis
  • Trauma
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5
Q

Presentation of hydrocele

A
  • Painless swelling in groin/scrotum

- May increase in size throughout the day

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6
Q

Describe transillumination of hydrocele

A

NOT diagnostic

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7
Q

Diagnosis of hydrocele

A
  • Clinical

- US to confirm

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8
Q

Treatment of hydrocele in children

A

Watchful waiting

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9
Q

Treatment of hydrocele in adults

A

Surgery

  • Open hydrocelectomy and endoscopic (low recurrence rate)
  • Aspiration and sclerotherapy (high recurrence rate)
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10
Q

Define varicocele

A

Dilated vein of spermatic cord

“bag of worms” appearance

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11
Q

What is the MC correctable cause of infertility in men?

A

Varicocele

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12
Q

Presentation of varicocele

A
  • Often asymp in children
  • Occasionally painful or heavy sensation worse w/prolonged standing (improved when supine)
  • Infertility
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13
Q

Treatment of varicocele

A
  • Symptomatic (scrotal support, analgesics)

- Surgery (venous ligation or embolization)

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14
Q

Define spermatocele

A

Benign cystic accumulation of sperm that arises from head of epididymis

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15
Q

Treatment of spermatocele

A

No tx if asymptomatic

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16
Q

Etiology of epididymitis

A

Infectious

  • Men under 35: STD (GC/chl)
  • Men over 35: urinary tract (E coli)
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17
Q

Risk factors of epididymitis

A
  • All sexually active men

- Prepubertal and men over 35: recent urinary tract surgery, anatomic abnormalities

18
Q

Presentation of epididymitis

A
  • Testicular pain and swelling (usually gradual onset, often unilateral)
  • Fever/chills
  • Urinary tract symptoms may be present
19
Q

PE findings of epididymitis

A
  • Swollen and tender
  • Testes in normal anatomic position
  • Pain may be relieved w/testicular elevation
  • Cremaster reflex intact
20
Q

Diagnosis of epididymitis

A
  • Based on PE findings and confirmed by lab testin

- Imaging not warranted unless you suspect torsion (but performed in most cases)

21
Q

Treatment of epididymitis

A
  • Treat empirically then adjust based on culture results

- Symptomatic tx

22
Q

Define orchitis

A

Acute inflammatory reaction of the testis secondary to infection

23
Q

Most cases of orchitis are a/w what?

A

Viral Mumps infection (but other viruses/bacteria can cause orchitis)

24
Q

What are most bacterial orchitis cases a/w?

A

Epididymitis (and occurs in sexually active men or over 50 d/t obstruction)

25
Q

Who is MC affected by orchitis?

A

Children w/mumps

26
Q

Treatment of orchitis

A
  • Supportive care

- Antibiotics if bacterial

27
Q

Complications of orchitis

A

Most resolve w/o complications

28
Q

Define testicular torsion

A

Twisting of spermatic cord causing obstructed blood flow

*Surgical emergency!

29
Q

Types of testicular torsion

A
  • Torsion of testis (more severe)

- Torsion of appendix testis

30
Q

Risk factors of testicular torsion

A
  • Bell clapper deformity of intravaginal torsion (congenital, 90%)
  • Testicular tumor
  • Hx of cryptorchidism (undescended testicle)
31
Q

PE findings of testicular torsion:

A
  • Testicle is NOT in normal position

- Cremaster reflex absent

32
Q

What is diagnostic for torsion of appendix testis?

A

Blue dot sign (tender nodule w/blue discoloration on upper pole of testicle)

33
Q

Treatment of testicular torsion

A

Immediate surgery

34
Q

Treatment of appendix testis

A

Conservative tx w/rest and pain meds

35
Q

MC cause of urethritis

A

STD

36
Q

Types of urethritis

A
  • Gonococcal
  • Nongonococcal
  • Idiopathic
  • Trauma related
37
Q

What confirms diagnosis of urethritis?

A

Urethral discharge

38
Q

Treatment of gonococcal urethritis

A

Ceftriaxone or cefixime

39
Q

Treatment of nongonococcal urethritis

A

Azithromycin or doxy

40
Q

Treatment of trichomonas urethritis

A

Metronidazole

41
Q

Prevention/patient education of urethritis

A
  • Abstinence x 1 wk after treatment as long as symptoms have resolved
  • All sexual partners from last 60 days should be treated

Clin Med III - GU/Renal (9 decks)

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