Male Reproductive Flashcards
Testicular Cancer
-Major cancer in men 15-34
Testicular Cancer: Risk factors
Family history
Caucasian
Cryptorchidism (major) (10% of all cancers) (Testes do not descend) (Higher it is located –> higher chance for cancer)
HIV infection
Teste Cancer: Germ cell tumors
Make up 95% of all teste cancers
Serminomas
Nonseminomas
Serminomas
-arise from immature germ cells
-slow growing, non aggressive
-easily cured with radiations
Nonseminomas
-Airse from mature germ cells
-More aggressive
-Usually treated with surgery
Early Clinical Manifestations of Teste Cancers
-Enlargement of testicle with painless mass noted
-If discomfort is present usually ache in groin or sensation of heaviness
Late clinical manifestations of testicle cancer
Frank pain
PAIN BASED ON METASTATIC SPREAD
Cough and hemoptysis
Swelling of lower extremities
Back pain
Dizziness
BPH
Begning prostatic hyperplasia
The Prostate
Gland surrounding the urethra
Produces seminal fluids
Weigh 4-20 gm
Mechanical BPH
Increase of epithelial cells
Dynamic BPH
Increase smooth muscle cells
Risk factors for BPH
Age
Family history
Race/ethnicity
BPH Symptoms
Lower urinary tract symptoms
Frequency - Sudden urge - Pain - Dribbling
BPH Etiology: Two Theories
- Hormone imbalance
-testosterone and estrogen (estradiol) (increase of estrogen levels) - DHT accumulation
-What is DHT and where is it formed?
-Testosterone + 5 alpha reductase –> DHT
-Why is it important in development of BPH?
Hormone imbalance BPH theory
-testosterone and estrogen (estradiol) (increase of estrogen levels)
As we age test decrease while estrogen increase. Creates a disbalance and increase the size of the prostate
DHT imbalance BPH theory
DHT formed by testosterone and 5 alpha reductase
DHT is a growth factors that accumulates as we age
DHT accumulation works as a growth factors that causes
Acts on skin: acne
Acts on hair on chest but off scalp
Stimulate growth of prostate cells
BPH: Clinical Manifestations
-Frequency and urgency
-Delay in initiation
-Reduction in force
-Increase urination time
-Dribbling
BPH: complications
Obstruction (impair kidney fuction)
UTI
Renal problems
Treatment of mild BPH
Mild symptoms = Watchful waiting
Treatment of moderate BPH
Drugs
5-alpha-reductase
Alpha1-adrenergic antagonists
Treatment of severe BPH
Invasive surgery
Prostate Cancer
Most common know cancer in the US
2nd to lung cancer is cancer related deaths
Increases rapidly after age 50
Prostate Cancer: RF’s
Age
Familial tendency (1st or 2nd degree increases risk 8 fold)
High fat diet
Prostate Cancer Clinical Manifestations
Late only:
BHP type presentation
Bone pain (most common)
Lungs (coughing up blood)
Prostate Cancer: Progonosis
-Stage dependent
-Early diagnosis
Prostate CA prognosis
Does not kill everyone
Low, intermediate, and high grade CA
Severity of prostate cancer depends on
Gleason score: (higher = worse)
Tumor volume: PSA level and number of cores
Erectile Dysfunction is known as _______ and is the _________…
Impotence
Inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse
ED is associated with
chronic illness
Primary ED
Rare
Life long inability to have a normal erection
Primary ED RF’s
Severe psychiatric problems
Early vascular trauma
Secondary ED
Most common
History of normal erections and then is unable to get it up
Secondary ED: Organic Cause
PVD
Medications
Endocrine problems
Trauma - surgery (radical prostatectomy)
Secondary ED: Psychogenic Cause
Depression
Low desire
Performance anxiety
Strained relationship
Physiology of Normal Erection
Sexual arousal leads to increase in the parasympathetic nervous system and nitric oxide release. This activates cGMP which relaxes arteries and smooth muscles which increases the inflow to the penis and reduces the outflow from the penis.
What enzyme is responsible for activates an erection
cGMP
What enzymes is responsible for inhibiting the erection
PDE-5
