Male Reproductive Pathophysiology Flashcards
Where is blood going to fill during an erection?
Corpus Colosseum
What is a hypospadias?
Congenital anomaly –> ventral location of the urethral opening (androgen mediated)
Urethral groove forms inappropriately and does not close
What are risk factors for hypospadias?
Preterm
Maternal Diabetes
Paternal history
Fetal Growth Restriction
What is epispadias?
Urethra opening on the dorsal side of the penis
What are paraphimosis?
Urologic Emergency!
Prepuce that has been retracted proximal to the glans - occurs when pt pulled prepuce back and not returned
Why is paraphimosis an emergency?
Prepuce is going to act as a tourniquet which will lead to necrosis of the glans
What is the presentation of paraphimosis?
Presents with pain, edematous prepuce, and shaft will be flaccid
What is phimosis?
Prepuce is stuck over the glans of the penis
Unable to retract, can develop fibrous scar tissue ring
What nerves are being stimulated causing an erection?
S-2, S-4
Erections are controlled by what branch of the nervous system?
Parasympathetic
Describe the normal erection physiology?
Ach acts directly on the vasculature to increase NO –> vasodilation
Erectile tissue will fill with blood –> venous drainage occluded
Detumescence occurs when there is a loss of NO
Why are diabetics at an increased risk of erectile dysfunction?
Decreased NO synthase
What are two conditions that will create issues with NO synthesis leading erectile dysfunction?
Atherosclerosis
DM
What are some etiologies of erectile dysfunction?
Vascular
Neurologic
Local penile factors
Hormonal
Drug induced
Psychologic
Is erectile dysfunction associated with cardiovascular disease?
Yes
What is Peyronie’s Disease?
Fibrous deposition within the tunica albuginea of the corpora cavernosa
Palpable along dorsal aspect of the penis
What is priapism?
Erection > 4 hours not associate with sexual stimulation
Is priapism considered an emergency?
Yes, blood within the penis is going to clot (compartment syndrome of the penis)
What are the low-flow causes of priapism?
- Decreased venous return
- Elevated pressure may lead to ischemia
- Medications, sickle cell
What are the high-flow causes of priapism?
- Less common
- Associated with increased arterial inflow not balanced by venous outflow
- Less painful
- Associated with trauma
When does the prostate stop rapidly growing?
Age 30
Dihydrotestosterone is a metabolite of what?
Testosterone and metabolized by 5a-reductase
What is prostatitis?
Inflammation of the prostate…its a big deal!
Starts off with similar symptoms of a UTI
Prostatitis is an ascending infection typically associated with GI pathogens, what is the most common pathogen?
E. coli
What is a hydrocele?
Tunica vaginalis envelops testis, folds on itself like fist in a balloon
Common in newborns
Epididymitis is most commonly associated with
STI’s (gonorrhoeae and trachomatis)
What are the risks of epididymitis?
abscess, infertility, infarction
Orchitis is classically associated with what vaccine preventable infection?
Mumps
Testicular torsion is a surgical emergency and requires intervention within how many hours of onset?
6 hours
