Male reproductive Flashcards
What is Hypospadius
Epispadius?
Urethra on ventral side of the penis
Urethra on dorsal side of the penis
What causes hypospadias
congenital abnormality that is androgen mediated
Urethra does not close appropriately
What happens during urination with hypospadias
Spraying of stream out the side of the penis
Wil have increased bed wetting / incomplete voiding
What are some effects of epispadias
incontinence, reflux, UTI
Severe cases can lead to bladder exstrophy
What is phimosis
inability to retract foreskin
What is paraphimosis
What can it lead to
Urologic emergency
Entrapment of the foreskin in the retracted position
Necrosis on the glans
How will someone with paraphimosis present
Painful and edematous prepuce
flaccid shaft
What can occur with phimosis
a fibrous scar tissue ring from the foreskin not retracting over the glans
What can cause phimosis
What may increase the risk of development
Skin conditions or blantitis leading to scaring and possible urinary obstruction
smegma buildup
Where in the body does the stimulus for an erection begin
hypothalamus
What physiologically occurs for an erection to form
Ach acts directly on the vasculature to increase NO = vasodilation and the erectile tissue will fill with blood
When does detumescence occur
when there is loss of NO
What is erectile dysfunction
inability of a man to maintain an erection sufficient for satisfying sexual activity
What are some underlying causes of ED
Issues with NO (DM/atherosclerosis)
Decreased testosterone
Neurologic
Endocrine dysfunction
psychological
medication SE
What is Peyronies disease
What does it cause
What disease is it associated with
Fibrous deposition within the tunica albuginea (dorsal aspect of penis)
Curved erection (15-20˚)
Dupuytren contracture
What is priapism
Erection> 4hr that is not associated with sexual stimulation
urologic emergency
How can you treat priapism
Phenylepherine into the corpus cavernosum to allow for vasoconstriction of arteries so blood can flow out of the penis
What does the glandular tissue in the prostate do
prostate specific antigen
cytokeratin
Contribute to ejaculation
What is required for growth of the prostate
When does majority of the prostate grow
Dihydrotestosterone (DHT)
puberty - 30y/o
Grown again from 40-50y/o
What metabolizes DHT
5a-reductase
What causes BPH
Where is growth the largest during BPH
Dysregulation of hormone balance
periurethral gland site
What are those with BPH at an increased risk for
hematuria
UTI
pyelonephritis
hydroureter
hydronephrosis
What is acute bacterial prostatitis associated with
What is the presentation
assocaited with GI pathogens (E. Coli)
also associated with STI
enlarged, tender, boggy
pain worse with standing
What is a hydrocele
tunica vaginalis envelopes testis and folds in on itself like a fist in balloon
Fluid develops between parietal / visceral layer
What is the most common cause of scrotal swelling
Who is it common in
Hydrocele
newborns
What is the cause of a primary hydrocele
Secondary?
Idiopathic
infection / trauma
Overall, generally d/t poorly functioning valves allowing for venous backflow
What is a varicocele
What does it look like
What side is most common
Dilation of pampiniform plexus
bag of worms
Left
What causes epididymitis in most people
In MSM population?
In those over 35?
STI (gonorrhea / trachomatis)
anal bacterial (E. coli / H. Flu/ TB)
enterobacter from intestinal flora
What causes orchitis
What is it classically associated with
When does it occur
bacteremia or direct spread up the urethra, through the prostate, up the vas defrens, through the epidymis, and into the testes
mumps
begins 3-4 days after parotitis
What causes testicular torsion
When will it occur
poor fixation of the lower pole of the testis
after exertion but can be spontaneous
may twist and untwist on its own
What causes necrosis with testicular tortion
How quicly does it need to be treated
twisting of the testes AND spermatic cord
surgery Within 6 hours
What causes a little blue dot on the testicle with testicular tortion
Necrosis of the testicular appendage
“little vesicular dingleberry”
