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Practice Topics Exam 4 > Male Reproductive Disorders > Flashcards

Male Reproductive Disorders Flashcards

1
Q

Prostatic pain conditions - Category 1

A

Acute bacteria prostatitis

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2
Q

Prostatic pain conditions - Category 2

A

Chronic bacteria prostatitis

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3
Q

Prostatic pain conditions - Category 3

A

Non bacterial prostatitis, prostatodynia, chronic prostatitis/chronic pelvic pain syndrome

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4
Q

Prostatic pain conditions - Category 4

A

Asymptomatic inflammatory prostatitis

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5
Q

Category 3 - Non bacterial/chronic pelvic pain syndromes - diagnostic tests

A

Physical exam is unremarkable
Might have tenderness at prostate
Urine test with white or red blood cells
No bacteria present

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6
Q

Category 3 - Non bacterial/chronic pelvic pain syndromes - treatment

A

NSAIDS or alpha blocker to relax muscle in prostate

PT

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7
Q

Category 3 - Non bacterial/chronic pelvic pain syndromes - Symptoms

A 
Blood in urine or semen
Inc urine urgency and frequency
Dec urinary stream
Pain or burning with urination
Pain patters vary - suprapubic, perineal, low back, scrotum, urethra, penis)
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8
Q

PT implications in prostatitis

A

Screen for fever/chills, frequent and painful urination, erectile dysfunction
Unknown cause of back pain in younger males (under 45) may be chronic prostatitis (more of a spasm of PFM)

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9
Q

Benign prostatic hyperplasia (BPH) is what

A

Enlargement of prostate gland

Grows from pea size to walknut shape

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10
Q

Benign prostatic hyperplasia (BPH) - epidemiology

A

Commonly begins around 40-50 yrs old
75% of males over 50 yrs old
Theory based on hormonal changes related to aging

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11
Q

Benign prostatic hyperplasia (BPH) - growth of prostatic tissue takes over

A

true prostate tissue which encroaches on prstatic urethra leading to symptoms

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12
Q

Benign prostatic hyperplasia (BPH) - symptoms

A 
Urinary obstruction
Hesitancy and itnermittency
Weak stream
Terminal dribbling
Overflow incontinence
Straining to void
Trigone hypertrophy
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13
Q

Benign prostatic hyperplasia (BPH) - advanced symptoms of urinary retention

A 
Post void residual
Bladder infection
Bladder, kidney stones
Hematuria
Retention, kidney failure, death
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14
Q

Benign prostatic hyperplasia (BPH) - diagnosis

A

Digital rectal exam
Urodynamic tests
Abdominal US
Elevated PSA levels call for tissue biopsy

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15
Q

Benign prostatic hyperplasia (BPH) - treatment

A

Mild - monitor condition
Meds - Alpha adrenergic blockers to relax bladder neck, 5 alpha reductase inhibitors to shrink glandular tissue
Surgical - TURP, TUIP

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16
Q

Benign prostatic hyperplasia (BPH) - PT implications

A

Screen for obstructed voiding
Bladder training if overactive or inc freqnecy
Strength training for incontinence related to BPH procedures

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17
Q

Benign prostatic hyperplasia (BPH) - PT implications - screen for obstructed voiding

A

Urinate more than every 2 hours or more than once a night
Difficulty in starting urine flow
Weak flow of interrupted stream
Sensation of incomplete bladder emptying

18
Q

Prostate cancer - epidemiology

A

1st most common cancer in men
2nd leading cause of cancer death
Most common malignancy diagnosed in men
4th leading source of neoplastic metastasis to spine
Bony metastases are common to spine, ribs, pelvis

19
Q

Prostate cancer - risk factors

A 
Age over 50
African American (2:)
Family hx
High fat diet
Alcohol consumption
Environmental toxins
Geography (US and Scandinavian)
20
Q

Prostate cancer - symptoms

A

Early in disease is asymptomatic

Late in disease - hematuria, impotence, metastasis to bone

21
Q

Prostate cancer - diagnosis

A

Digital rectal exam
Elevated PSA levels calls for tissue biopsy
TRUS
Urodynamic tests
Abdominal US, CT and MRI
Bone scan (only if PSA over 20 to check for metastasis)

22
Q

Prostate cancer - treatment

A

Watchful waiting being used more often
Radiation therapy
Hormonal therapy (androgen deprivation meds)
Surgery

23
Q

Prostate cancer - treatment - surgery - adverse effects of surgery

A

Sexual - ED (7/10 due to injury to nerves innervating penis)
Urinary - stress incontinence
Urinary obstruction - scar tissue btw urethra and bladder neck

24
Q

Prostate cancer - post prostatectomy

A

Hospital stay 2-5 days
Pain mngmt and antibiotics
Catheter in place for 1 to 3 wks
Allow time for healing

25
Q

PT implications with prostate cancer

A

Screening men with pre existing prostate conditions
Establish baseline for urinary function and note changes over time
Non mechanical back pain in thoracic, lumbar, and sacral area may be metastatic spread to axial skeleton

26
Q

PT implications with prostate cancer - what else besides screening

A

Pre-operative pelvic floor training
After radical prostatectomy - PFM reed, biofeedback
Complications of med tx include infection, incontinence, sexual dysfunction
Exercise

27
Q

Male urinary incontinence - epidemiology

A

Wide range reported in lit due to surgical technique and defining incontinence (6-87%)
Post prostatectomy incontinence up to 60%
Incidence is equal to females - just happens later in life

28
Q

Males and continence

A

Urethral pressure is more than bladder pressure

29
Q

Males and continence - major contributors

A 
Smooth mm sphincter - removed in prostatectomy, loss of tonic mm support
Striated urethral sphincter
Levator ani
Bulbocavernosus
urethral mucosa
30
Q

Male urinary incontinence - treatment

A

Medication
Surgery
Injection of bulking agents
Pelvic floor muscle exercises

31
Q

Male urinary incontinence - treatment - PT

A 
Education
PFM training
Biofeedback
Focus on urethral mechanism with most effective cues to retract penis
Breath training with PFM integration
Train pre activation of PFM before exertion
Facilitation of PFM
Bladder training
32
Q

Screening questions for pelvic floor - for all patients!

A 
Do you ever leak urine or stool
Do you ever wear a pad
Do you have pain with intercourse
Do you have genital or pelvic pain
Do you have difficulty emptying your bladder completely 
Do you have constipation
33
Q

Testicular cancer - epid

A

One of the most curable cancers (greater than 95%)
Less than 1% of all cancers
Most common solid tumor of young adult, males 15-35
Greater risk in higher SES
White:Black 5:1
Tx is surgical removal of the testis

34
Q

Testicular cancer - PT

A 
Post surgical:
lymphedema tx
Posture and mvmnt dysfunction 
Possible sexual dysfunction
Side effect from chemo and radiation
35
Q

ED is what

A

Inability to achieve or maintain erection sufficient for satisfactory sexual performance

36
Q

ED - organic

A

85% of men over 50 years
Impeded blood flow
Impeded nerve transmission

37
Q

ED - psychogenic

A 
70% of men less than 35 years
Anxiety
Fear
Depression
Stress/hypertonicity
38
Q

ED risk factors

A 
Age 
Smoking
Medical history - DM, CAD, Hypothyroid, hypopituitary, hypertension, chronic uremia, NM disease, psych, alcoholism
Surgical hx
Medications - antihypertensives
39
Q

ED treatment

A 
Control of underlying med condition
Evaluate medication list
Monitor testosterone therapy
Counseling
PFM strengthening program
Biofeedback for relaxation
Surgical - penile implant
Mechanical - penis pumps
40
Q

Sexual dysfunction screening

A

screen for cauda equina
post operative complication
Sex is an ADL too!!!

41
Q

Screening for sexual dysfunction - what do you say

A

Start with open ended ubiquity style question
Continue inquiry with specific questions
Follow up with positive response and open ended question

Practice Topics Exam 4 (9 decks)

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