male reproductive organs pathology Flashcards by Evie Mander

what is varicocele

enlargements of the veins within the scrotum (varicose veins)

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description of varicocele

bag of worms

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which side is varicocele most common on and why

left - increased resistance to flow as left gonadal vein drains into renal vein (right drains into IVC)

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what can left sided varicocele also be a presenting feature of

renal cell carcinoma

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what is spermatocele

fluid-filled cyst that develops at the head of the epididymis

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when would management of spermatocele be indicated

if cysts are causing pain or enlarging

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what is hydrocele

collection of fluid between the 2 layers of the tunica vaginalis

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what is the tunica vaginalis

mesothelial lining which surrounds the testes

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clinical presentation of hydrocele

soft, smooth, non-tender swelling around one of the testes

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clinical sign of hydrocele

transilluminates with light on examination with a torch

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what is the common name for condyloma

genital warts

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what causes genital warts

HPV - mostly 6 and 11

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histology of condyloma

papillomatous proliferation of squamous epithelium

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what is another name for lichen sclerosus of the penis

balanitis xerotica obliterans (BXO)

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what can BXO be associated with the development of

squamous cell carcinoma

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2 complications of BXO

phimosis and paraphimosis

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clinical presentation of lichen sclerosus

white pearly plaques + ulceration

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confirmatory diagnosis of BXO

skin biopsy

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name some risk factors for penile cancer

phimosis, HPV, smoking, immunocompromise

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what is the most common type of penile cancer

squamous cell carcinoma

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what is the most common site of penile cancer

glans

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clinical presentation of penile cancer

hard, painless lump

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diagnosis of penile cancer

biopsy
MRI to assess tumour depth

what is the most common solid cancer in men between 20-45

testicular cancer

what are the 2 main subtypes of testicular cancer

seminoma and teratoma

name some risk factors for testicular cancer

undescended testes, family history, HIV, previous history

what type of cell do testicular cancers most commonly arise from

germ cells

primary clinical presentation of testicular cancer

painless lump in the scrotum

why might patients with testicular cancer present with gynaecomastia

some germ cell tumours produce hormones so can increase the oestrogen:androgen ratio

first line investigation for a testicular mass

scrotal ultrasound

blood markers tested for in suspected testicular cancer and what they suggest

AFP: yolk sack tumour bHCG: choriocarcinoma LDH

2 week referral criteria for suspected testicular cancer

non-painful enlargement or change in shape or texture of the testis

management of testicular cancer

radical inguinal orchidectomy +/- sperm preservation

what is the most common cancer in men over 50 in the UK

prostate cancer

what is the most common type of prostate cancer and where do they arise

adenocarcinomas peripheral zone

where do prostatic cancers usually spread first lymphatically

obturator nodes

name some risk factors for prostate cancer

family history, increasing age, obesity, smoking

where is the most common site of prostatic cancer metastasis

bones

name some symptoms of prostate cancer

urinary symptoms: difficulty initiating, poor stream haematospermia, erectile dysfunction

initial examination for suspected prostate cancer

digital rectal exam, urine dip, PSA

name some things that can cause a falsely raised PSA

urinary infection ejaculation in previous 48 hrs vigorous exercise e.g. cycling interventions e.g. biopsy

gold standard investigation for suspected prostate cancer

trans-rectal US guided biopsy

what is used to stage prostate cancer histologically

gleason score

how can we determine if prostate cancer has spread

MRI and bone scan

what can be used to help slow the progression of metastatic prostate cancer

GnRH agonists, androgen antagonists

where in the prostate does BPH usually occur

transition zone

what does BPH stand for

benign prostatic hyperplasia

what does the prostate grow in response to

dihydrotestosterone

does BPH increase your risk of cancer

what is the most common symptom for BPH to present with

LUT dysfunction retention, dribbling, incontinence, hesitation

what is bladder outflow obstruction as a result of BPH associated with

retention, recurrent UTI, impaired renal function, haematuria

what is used to assess the severity of urinary symptoms in BPH

the IPSS score

what are the components of the IPSS score

- bladder (FUN): frequency, urgency, nocturia - outflow (SHIP): straining, hesitancy, intermittency, poor stream - quality of life

initial examination for suspected BPH

urine dipstick prostate exam PSA

medical therapy for BPH

alpha blockers for dynamic obstruction and 5-alpha reductase inhibitors to reduce prostate size

give an example of an alpha blocker

tamsulosin

give an example of a 5-a reductase inhibitor

finasteride