Male Infertility Flashcards
what is pathophys of peyronies?
connective tissue disorder where dense collagen plaque in tunica albuginea of penis leads to curvature of the erection
what is first line rx for ED?
PDE-5 inhibitors or testosterone therapy
explain the MoA of PDE-5 inhibitors
prevents breakdown of cGMP and this leads to increased cGMP and decreased intracellular calcium so more smooth muscle relaxation
what is generic name for viagra?
sildenafil
what is generic name for cialis?
tadalafil
if PDE-5 inhibitors dont work…what is a second lin option for ED rx?
direct injection of vasodilators into corpora cavernosa
what is primary hypogonadism?
testicular insufficiency
what is secondary hypogonadism?
pituitary insufficiency
what are sx of hypogonadism?
ED, low libido, low energy fatigue
how do you diagnose hypogonadism?
measure serum testosterone and below 300 ng/dl
what is the number 1 cause of infertilitiy in men?
varicocele
what happens in a varicocele
dilation of pampiniform plexus
how does varicocele lead to infertilitiy?
leads to hyperthermia or hypoxia of testicles
which side is more common to have a varicocele?
LEFT
what is karyotype of klinefelter?
XXY 47
what are features of klinefelter syndrome?
primary hypogonadism, infertility, tall stature gynecomastia
what is usual presentation of klinefeleter?
normal appearing male with hypgonadism and infertility
what is CBAVD?
congenial bilateral absence of the vas deferens
who gets CBAVD?
those with CF or CF carriers
what is a genetic thing that can cause severe oligospermia?
Y chromosome microdeletion
what hormone means you have normal spermatogenesis?
FSH
if FSH is low, what does that mean about spermatogenesis?
likely messed up…pre testicular failure
if FSH is high, what do you likely have?
testicular failure
what does exogenous testosterone cause to testes?
it will lead to them atrophy and cessation of spermatogenesis and infertility
what is first reccomended test in work up of infertility?
semen analysis
