male repro - patho - E2 Flashcards
what main age group does testicular cancer affect
men ages 15-34
younger
risk factors for testicular cancer (4)
-family hx
-caucasian
-cryptorchidism
-HIV infection
cryptorchidism
testicles usually descend by term birth but w/ this disease the testicles do not descend during the first 3 months of life
the higher the testicle, the higher the risk for developing cancer & if correction is not done by 12yrs, person has 2x higher risk
+in 25% of cases the cancer develops in the testicle that descended
what are the two types of germ cell tumors
seminomas & nonseminomas
germ cells are
the sperm forming cells in the testicles
seminomas germ cell cancer
-arise from immature germ cells
-slow growing, nonaggressive
-easily cured w/ radiation
nonseminomas germ cell cancer
-arise from mature germ cells
-more aggressive
-usually treated w/ surgery
early clinical manifestations of testicular cancer (4)
-enlargement of testicle
-painless mass noted
-ache in groin
-sensation of heaviness
95-99% survival rate at this stage
late clinical manifestations of testicular cancer
-possible frank pain
-manifestations based on spread:
cough, hemoptysis, swelling of lower extremities, back pain & dizziness
still 75% survival rate
the prostate
-gland surrounding the urethra
-produces seminal fluids
-weighs between 4-20g
how much can the prostate weigh w/ BPH
up to 50-80g
BPH
nonmalignant enlargement of prostate caused by excessive growth of epithelial cells & smooth muscle cells
the overgrowth of epithelial cells in BPH cause
a mechanical obstruction of the urethra
the overgrowth of smooth muscle cells in BPH cause
dynamic obstruction of the urethra
risk factors of BPH (3)
-age
-family hx
-race/ethnicity (highest in AA, lowest in asian)
BPH usually leads to what
lower UTI
BPH etiology theories
1) hormone imbalance (test goes down in age, estro does not)
2) DHT accumulation bc it stimulates growth factors & is affected by estrogen
BPH clinical manifestations (5)
-frequency & urgency
-delay in initiation
-reduction in force
-increased urination time
-dribbling
sx not correlated w/ size
BPH complications
-obstruction
-UTI
-renal problems (stones)
treatment for BPH
mild: watchful waiting
mod: drug therapy
sev: invasive options (surgery or microwave)
drugs for BPH
5-alpha reductase inhibitors
alpha 1 adrenergic antagonists
when a male is taking BPH meds & their prostate specific antigen (PSA) isn’t decreasing, what is the next step
get evaluated for cancer
prostate cancer risk factors (3)
-age
-familial tendency (8 fold)
-high fat diet (alters sex hormone productions)
prostate cancer clinical manifestations
early: asym
Late: BPH like, spreads to bone & lungs
prostate cancer survival rate
almost 100% if caught early
prostate cancer controversy
prostate cancer is very common but dying from the cancer is rare -> is we use the PSA screenings we increase the amount of prostate cancer we catch / prevent but the aggressive interventions might cause more harm then the cancer itself
gleason score measures what
likelihood of prostate cancer death
between PSA & digital rectal exams, what can catch prostate cancer first
PSA by 15 yrs
erectile dysfunction (ED)
“impotence”
inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse
primary ED
rare
-life long inability to have normal erection
-severe psychiatric problems
-early vascular trauma
secondary ED
most common
-ED in someone w/ a hx of normal erections
-organic cause: error in blood flow (peripheral vascular disease), medication (antidepressants & htn), endocrine or trauma/surgery
-psychogenic cause: mental (depression, performance anxiety)
physiology of a normal erection
sexual arousal -> inc PNS & nitric oxide release -> activation of cGMP -> relaxation of arteries & smooth muscles -> increased inflow and reduced outflow -> engorgement and erection
