Male Repro Flashcards by Sydney Book

What can cause BPH?

Aging
Hormonal changes
Decreased activity
ETOH/TOB
Diabetes

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What is DHT?

Sex hormone that stimulates prostate growth

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What happens as males age?

Decreased testosterone
Increase estrogen and DHT

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What are some complications of BPH?

Retention
UTI
Pyelonphritis
Bladder stones
Hydronephoresis

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How are bladder stones formed with BPH?

Urine becomes alkaline

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What is the PSA normal level?

O-6.5

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What does a TRUS do?

Differentiates between BPH and prostate cancer

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What is avoided with BPH?

Anticholergics and decongestants

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What two class of drugs is used to treat BPH?

5a-reductive inhibitors
A-adrenergic receptor blockers

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What are the names of the 5a-reductase inhibitors?

Proscar
Avodart

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What do the 5a-reductive inhibitors do for BPH?

Reduce size of prostate gland

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How long can proscar take to work?

6 months

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What does proscar do?

Decreases PSA levels

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What are the names of the a-adrenergic receptor blockers?

Flomax
Cardura
Mini press
Hytrin

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What do the a-adrengergic receptor blockers do for BPH?

Relaxes smooth muscle which increases urinary flow

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What is Jalyn?

Proscar and flomax taken together

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What is a common side effect of a-adrenergic receptor blocker?

Retrograde ejaculation

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What is an erectogenic med and what does it do?

Cialis
Symptom relief of BPH and ED

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What is a TUMT?

Heats prostate to 113
Destroys tissue which relieves obstruction of BPH

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What are the post op procedure do TUMT?

Retention is common
Sent home with foley for 2-7 days

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What is a TUNA?

Needle directly heats prostate with a laser
More invasive than TUMT

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What happens post op TUNA?

Hematruia for a week
Necrosis
Catheter

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What does TUNA use that TUMT does not

Low wave radio frequency

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What happens post op laser prostatectomy?

Retrograde ejaculation
Foley for 7 days
CANNOT HAVE KIDS

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How is a TURP performed?

Resectoscope inserted into urethra

What happens to ejaculatiin after TURP?

Can still ejaculate but it decreases semen ED unlikely

What is done post op TURP?

Bladder irrigation CHECK I/O

What is done pre op TURP and why?

U/A and CBC because UTI must be resolved before surgery

What do you not do pre op TURp?

restrict fluids

What can develop post op TURP?

Retrograde ejaculation

What are signs of TURP syndrome?

Hyponatremia N/V Confusion Bradycardia HTN

What can retrograde ejaculation lead to?

Decrease orgasmic sensations

What are 3 antispasmodics?

Ditto pan Pyriduium Belladonna

When are PSA test given?

Every 2 years ages 55-69

What is a TUIP?

Surgical procedure to relieve pressure of urethra

What does a TUIP do?

Cuts pieces of the prostate off instead of removing the whole thing

What treatment is given when kids are wanted?

TUIP

What increases the risk for prostate cancer?

Red and processed meats High fat dairy Low veg intake Increased testosterone

What is a radical prostatectomy?

Entire prostate removed Seminal vessicals anf neck of bladder removed

What are the surgical approaches for a radical prostatectomy?

Retropubic-bikini line Perineal resection- btw scrotum and anus

What are the complications of a radical prostatectomy?

ED and incontinence Hemorrhage Retention Wound dehiscence DVT Pulmonary emboli

What do you educate your pt about the complications of radical prostatectomy?

ED and inconteince will slowly return 24 months

What does androgen deprivation therapy do?

Decreases testosterone

What can happen from long term androgen deprivation therapy use?

Tumor becomes resistant Increase in PSA levels will tell if resistance has occured

What do androgen synthesis inhibitors do?

Acts on pituitary to decrease response of LH and testosterone

What would the results os a DRE show with prostatitis?

Extreme swollen prostate Tender and boggy

What are the complications of prostatitis?

Enlarged prostate Retention Epididymitis Cystitis

When is a u/a given for prostatitis?

Before and after vigorous prostate massage

What would the massage cause if the patient had prostatitis?

Inflammation If it didn’t cause inflammation it would be BPH

What is hypospadias?

Urethral opening is on the back of the penis

What is phimosis?

Tightness of the foreskin making it hard to retract

What is phimosis caused from?

Inflammation due to poor hygiene

What is the treatment for phimosis?

Topical steroid Circumcision

What is paraphimosis?

EMERGENCY Tightness of foreskin, difficulty pulling skin forward

What is the treatment for paraphimosis?

Push glans through skin using ice and compressions ATB Warm soaks

What is priapism?

EMEREGENCY Erection lasting longer than 4 hours

What are the complications of priapism?

Necrosis

What is the treatment for priaprism?

Blood transfusion Muscle relaxant (Phenylephrine)

What can cause priaprism?

Diabetes Sickle cell Spine trauma Drugs ED meds

What infections cause epididymitis?

Chlamydia and Gonerreha BPH and prostatitis

What is the treatment for epididymitis?

Ice Analgesics Elevate scrotum

What do you education your pt with epididymitis?

Discomfort and swelling last weeks-months Pain subsides in a week

What is orchitis?

Inflamed testes

What causes orchitis?

Viral infections Mumps Pneumonia TB Syphilis

What can orchitis cause?

Sterility

What is cryptorchisism?

Undeserved testes prior to birth

What can cryptorchidism cause?

Infertility (right teste)

What is a hydrocele?

Non-tender fluid filled mass in scrotum

What is the cause of a hydrocele?

Lymph drainage

Why is surgery a last resort for a hydrocele?

Can cause infertility

What is a testicular torsion?

EMERGENCY twisting of the spermatic cord

What is done immediately for a testicular torsion and why?

Surgery 4-6 hour of no blood flow leads to ischemia and necrosis

How do you diagnose testicular torsion?

US to see blood flow

What is a spermatcele?

Firm sperm containing caste of the epididymis

What is a varicocele?

Dialation of veins that drain the testes

What does a varicocele feel like?

Worm like scrotum

What are the signs of testicular cancer?

Painless lump in scrotum Heaviness and swelling No tender and firm

How do you diagnose testicular cancer?

US and blood draw

Testicular tumors are more common in males who

Have had undecended testes Family hx

What is penile cancer?

Squamous cell carcinoma

What increases the risk of penile cancer?

HPV Phimosis Uncircumcised

What is a sign of penile cancer?

Superficial ulceration Pimple like nodule

What is the treatment of early stages of penile cancer?

Laser removal

What medicine increase the risk for ED?

Tricyclic antidepressants Antilipidemic Antihypertensives Antiandrogens

What vascular problems increase the risk for ED?

Atherosclerosis HTN Peripheral vascular disease

What endocrine problems increase the risk for ED?

Diabetes Hypogonadism Obesity

What genitourinary problems increase the risk for ED?

Radical prostatectomy Renal failure

What neuro problems increase the risk for ED?

CV Parkinson’s Trauma Tumors of spine

What is hypogandism?

Small testes Decrease testosterone

What are the erectogenic drugs used for ED?

Viagra CIalis Stendra Staxyn

What cannot be taken with erectogenic drugs?

Nitrates

If erectogenics are taken with nitrates what will happen?

Immediate extreme decrease in BP

What are common side effects of erectogenic drugs?

HA Flushing Congestion Dyspepsia

What is the most common cause of male infertility

Varicocele