Male reproductive Flashcards
testicular cancer
Known cause of male sterility
Affects ages 15-34
risk factors of testicular cancer
Family history
Caucasian
HIV infection in aids stage
Cryptochidism-empty scrotum at birth
Germ cell tumors
Sperm forming cells
Seminoma’s
immature germ cell
Slow growing, nonaggressive
Easily cured with radiation
Non-seminoma’s
mature germ cell
More aggressive
Treated with surgery
early s/sx germ, cell tumors
Painless, enlarged mass of testicle
If discomfort, acne in groin or abdomen
Sensation of heaviness in scrotum
late s/sx germ cell tumors
Possible Frank pain
Based on metastatic spread
Cough, hemoptysis
Swelling of lower extremities
Back pain
Dizziness
Benign prostatic hyperplasia
nonmalignant enlargement of prostate
Increases epithelial cells in smooth muscle cells
prostate
Gland surrounding urethra
Produces seminal fluids
how much does a healthy men’s prostate weigh?
4-20 g
Walnut size
Risk factors for BPH
older men
Family history
Race/ethnicity
Which race is at most risk for BPH
African-Americans
which race is at least risk for BPH
Japanese
BPH etiology
1– hormone inbalance
2– DHT accumulation
hormone imbalance
decreased testosterone
Increased estrogen = growth factors of prostate
DHT accumulation
Testosterone + 5 alpha reductase
Acts on skin – acne
Acts on hair follicles – chest, but off scalp
Stimulates growth of prostate cells
s/sx BPH
frequency urgency
Delay in initiation
Increased urination time
Dribbling
Reduction in force
Is there a link between size in prostate and symptoms?
No
Complications with BPH
obstruction – nephropathy
Recurring, UTI, bladder stones
Renal problems
treatment for mild symptoms
Watchful waiting, annual reevaluation
treatment for moderate symptoms
Drug therapy
Treatment for severe symptoms
invasive surgery
Microwave therapy
prostate cancer
Most common male cancer in US
What race is most at risk for prostate cancer?
African-American males
What race is that lowest for prostate cancer?
Asians and Native Americans
Risk factors for prostate cancer
> 50 years
familial tendency
High fat diet
early s/sx prostate cancer
Asymptomatic
later s/sx prostate cancer
BPH type presentation
Meta-stasis to bone and lungs
Severe pain, cough, sputum
prognosis of prostate cancer
Stage dependent
Early diagnosis – better
controversy
Most common cause of cancer deaths
Most prostate cancer grows slowly that men die of other causes
Mini cases never become clinically relevant
Survival depends on stage spread
PSA screening
Prostate specific antigen
Questionable benefit
Detects earlier cancer diagnosis
Potential harms from preventable treatments - ED, urinary incontinence, bowel problems
Mini unnecessary biopsies
prognosis of prostate cancer
Prostate cancer doesn’t kill everyone
Low, intermediate, high-grade cancer
Gleason score
Higher=worse
Tumor volume
higher PSA level= worse
More number of cores= worse
PSA testing versus digital rectal exam
PSA-if history, increased risk
Digital rectal exam – decrease risks
Erectile dysfunction
impotence
Inability to achieve or maintain erection, sufficient for satisfactory sexual intercourse
Associated with chronic illness
primary ED
Rare
Lifelong in ability due to severe psychological problems in early vascular trauma
secondary ED
Most common
History of normal directions progresses to inability
Organic or psychological causes
organic causes
PVD – insufficient, arterial flow, excessive, venous, drainage, sedentary lifestyle
Meds – antidepressants, antihypertensives
Endocrine problems – decreased testosterone
Trauma, surgery
psychological causes
Depression
Low desire
Performance anxiety
strained relationship
physiology of normal erection
sexual arousal
Increased PNS and nitric oxide release
Activation of CGMP
Relaxation of arteries and smooth muscles
Increased inflow and decreased outflow
Engorgement an erection
Priapism
painful erection
>4 hours
Medical emergency
