Men’s Health Flashcards
Lies just under the bladder and surrounds urethra (Walnut size in young men and enlarges with age)
Prostate
Puberty is boys begins as early as ___ & may continue until ___
9; 16
Gradual decrease in testosterone levels thaat occurs with aging
Andropause
Testosterone starts to naturally decrease around ___
30
Aging of the Male Reproductive System: Physical Sx
– Decreased: Muscular strength/mass & bone density
– Increased body fat
– Fatigue and anemia
Aging of Male Reproductive System: Emotional Sx
– Decreased motivation and mood
– Decreased mental sharpness and acuity
– Low energy
– Difficulty concentrating
Aging of the Male Reproductive System: Sexual Sx
– Reduced libido
– Difficulty getting or keeping an erection
–Loss of pubic or underarm hair
– Small or shrinking testes
Low Testosterone: Causes other than age
• Chronic liver & kidney disease
• Alcoholism
• Diabetes
• COPD & other lung disease
• Pituitary gland issues
• Mumps
• Genetic conditions: Undescended testicles & Klinefelter’s syndrome
• Physical injuries to testicles
• Obesity • Stress
• Cancer treatment
• Medications: Opioids, steroids
Enlargement of breasts in males
Gynecomastia
Gynecomastia: Physiological vs. Pathological
-Physiological: Infants/boys (normal), men >50
-Pathological: Drugs, idiopathic, persistent pubertal
Male Breast Cancer: Symptoms
– Painless lump or thickening,
– Skin changes: dimpling, puckering, redness, scaling
– Nipple changes: redness, scaling, inward nipple,discharge
Gynecomastia and Breast Cancer: Red Flags
Recent onset of:
-Painful, tender, testicular mass
-Eccentric swelling
-Nipple discharge
Gynecomastia & Breast Cancer: Exam
• Look for:
-Consistency, fixation to skin
-Dimpling
-Nipple retraction
-Lymph node enlargement
UTIs in males are uncommon under ___
50
UTI (Males): Common Causes
– Prostate issues (BPH, prostatitis)
– Urethra issues: strictures, urethritis, catherizations
– Testicular issues: epididymitis, orchitis
– Kidney issues: pyelonephritis
– Other: STI, can’t empty bladder fully, DM
Factors that can affect Testosterone changes in a Male
-Alcoholism
-Chronic Liver & Kidney Disease
-Genetic Conditions (Kleinfelter’s Syndrome & undescended testicles)
-Diabetes
-COPD/lung disease
-Pituitary gland issues
-Mumps
-Physical injuries to testicles
-Obesity
-Stress
-Cancer treatment
-Medications (opioids/steroids)
Physiological vs. Pathological Gynecomastia
-Physiological: Infants/Boys (6 months-2 years)
-Pathological: Drugs, Idiopathic, Prolonged Puberty
Causes of Urethritis
-Causes: Bacteria from STI (Gonorrhea, Chlamydia)
Complications of Urethritis
-Can cause urethral scarring & stricture
-May spread into bladder
-May spread into the gender organs (Men: Epididymitis)
Balanitis
Acute inlammation of the glans;
Causes of Balanitis & inflammatory conditions of penis
Causes: Fungal/bacterial infection, trauma, allergy, STD
Posthitis
Inlammation of the foreskin
Balanoposthitis
Inlammation of both the glans & foreskin
-Balanitis xerotica obliterans:
Chronic inlammation causes skin to harden & turn while - May eventually block low
Phimosis
-Phimosis: Foreskin is tight & can’t be retracted over the glans;
Causes of Phimosis
Causes: In Older men-may be caused by prolonged irritation or prolonged balanoposthitis (Normal up to age 5)
Paraphimosis
-Paraphimosis: Retracted foreskin cannot be pulled forward to cover glans (glans swells and traps foreskin);
Causes of Paraphimosis
Causes: Catheterization or cleaning after medical procedures
Urethral Stricture
Urethral Structure-Decrease stream or double stream with mild stricture
Cause of Urethral Stricture
-Cause: Typically none but can result from previous injury
Peyronie’s Disease
Peyronie’s Disease: Hard cord like ibrotic scar tissue in penis that gives abnormal curvature to penis
Causes of Peyronie’s Disease
-Cause: Possible trauma or beta blockers
Testicular Cancer
Testicular Cancer: Firm lump or enlarged testes
Testicular Cancer: Cause
-Cause unknown, but common in young men ages 15-35
Testicular Torsion
Testicular torsion: Twisting of the spermatic cord causing alterations to blood supply
Testicular Torsion: Cause
-Causes: 1/3 have had prior testicular pain and may be more common in winter
Hernias
Hernias: Protrusion of intestinal contents through acquired or congenital area of weakness or defect in abdominal wall
MC Hernia
Inguinal (75%)
Indirect Inguinal Hernia
-Indirect inguinal: MC, all ages, both sexes (Often into scrotum; Hernia comes down touches ingertip)
Direct Inguinal Hernia
-Direct Inguinal: Less Common (Rarely into scrotum; Hernia bulges anteriorly & pushes side of inger forward)
Femoral Hernia
-Femoral: Least common (Never into scrotum; upper thigh next to groin, inguinal canal is empty.
Epididymitis
-Epididymitis: Inlammation of epididymis with scrotal pain
Epididymitis: Cause
Cause: Bacterial infection due to STI, distal urinary tract obstruction, surgery or catheter, cystitis, prostatitis
Orchitis
-Orchitis: Inlammation & infection of testes usually caused by virus
Orchitis: MC Cause
MC Cause: Mumps
Scrotal Edema
-Scrotal Edema: Retaining large amounts of luid
Scrotal Edema: MC Cause
Cause: Right ventricular failure
Hydrocele
-Hydrocele: Collection of luid within scrotum
Hydrocele: Cause
Causes: Often unknown; May result from epididymitis, cancer etc.
Injuries to Penis
-Cuts: Catch on zipper
-Urethral Injury: Blunt injury like straddling fence, bike, surgical procedures, deep cuts
-Fracture: Excessive bending (emergency procedure)
-Severed: Rare recovery of sensation or function (emergency)
Testicular Torsion can lead to _____ & testis can die within ______ hours
Acute Ishemia & 6-12 hours
Testicular Torsion: Signs & Symptoms
-Rapid onset
-Severe, local pain
-Nausea & Vomiting
-Scrotum: enlarged, red, edema
-May have fever & urinary frequency
-Absent cremaster relex
Testicular Torsion: Management
-Emergency situation
-May untwist by rotating it within scrotum
-If unsuccessful, immediate surgery
Testicular Cancer: Risk Factors
-Risk Factors: Caucasian (especially Scandinavian), history of cryptoorchism, Family Hx Signs/Symptoms
Testicular Cancer: Signs & Symptoms
-Firm lump or enlarged testes
-Usually painless, but can have a dull ache in abdomen or groin
-Sensation of fullness/heaviness
With Testicular Cancer, you may have:
-May have: Hydrocele, Acute or chronic epididymitis, Lymph involvement
Hernia: Risk Factors
-Heavy lifting
-Chronic coughing
-Straining with urination
-Straining due to chronic constipation
-COPD
Epididymitis vs. Orchitis: Signs & Symptoms
-Epididymitis: May radiate into the groin, Fever & Chills if severe, urinary symptoms, Hydrocele may occur
-Orchitis: Hematuria & ejaculation of blood
Epididymitis vs. Orchitis: Cause
-Epididymitis: STI, Distal urinary tract obstruction, surgery or catheter, cystitis or prostatitis
-Orchitis: Mumps
Spermatocele vs. Varicocele: Signs & Symptoms
-Spermatocele: Mass w/ Palpation & Transiluminates
-Varicocele: Feels like a bag of worms, throbbing/aching/sense of fullness that is worse with standing
Spermatocele vs. Varicocele: Treatment
-Spermatocele: No treatment: Unless large & bothersome (surgery)
-Varicocele: Surgical Correction
BPH, Prostatitis, Prostate Cancer: Age
-BPH: >50 yoa
-Prostatitis: <50 yoa
-Prostate Cancer: >50yoa
Decongestants & antihistamines for colds/allergies is contraindicated for which prostate condition?
BPH
Prostate Conditions: BPH vs. Prostatitis vs. Prostate Cancer (Signs/Symptoms)
-BPH: Difficulty Initiating, Nocturia, Decreased force/volume
-Prostatitis: Bladder/pelvic spasm, Dysuria/Burning, constipation & painful erection/ejaculation
-Prostate Cancer: Asymptomatic initially, hematuria, straining, weak/intermittent stream
Why is it difficult to diagnose prostate cancer
-PSA may not be elevated in someone with cancer
-PSA can be elevated for other reasons like aging, BPH, prostate stimulation, UTI or certain meds
STIs
Chlamydia, Syphilis, Chancroid, Granuloma Inguinale
STDs
-Genital Warts, Genital Herpes, Scabies
Chlamydia Trachomatis: Cause
-STI caused by bacteria
-Affects young women mostly
Chlamydia: Sx
-Dysuria
-Discharge from Penis
-Testicular Pain possible
Syphilis: Cause
-Bacterial Infection: Treponema pallidum
Syphilis: Cause
-Bacterial Infection: Treponema pallidum
Syphilis: Stages
Stages:
1st: : Painless ulcer, headaches, malaise
2nd : Non itchy rash
3rd: Little to no symptoms
4th: Neuro/cardiac S/Sx
Chanroid: Cause
-Bacterial infection through sexual contact
-Caused by bacterium
Chancroid: Sx
-Painful ulcer
-Well defined borders
-Necrotic base
-May easily bleed
-May have purulent discharge
-Tender inguinal lymph nodes
Granuloma Inguinale: Cause
-Sexual contact (Klebsiella granulomati)
Granuloma Inguinale: Sx
-Painless beefy red nodules
-Gradually enlarges
-Often affects genitals or anus
-Bleeds on contact
Genital Warts: Cause
-Caused by human papillomavirus
-Risk Factor: Multiple partners
Genital Warts: Symptoms
-Painless genital bumps or growths
-Can be flat or may “cauliflower”
-Itchy
-Possible discharge
-Often multiple
Genital Herpes: Cause
-Caused by herpes simplex virus
-Increased risk of HIV
Genital Herpes: Symptoms
-Initial Symptom: Genital tingling
-Followed by outbreak or eruption of small, painful, fluid filled blisters
-Heals with crusting
-May have dysuria
-Possible urethral discharge
-Tender inguinal lymph nodes
Scabies: Cause
-Skin infection caused by parasite
-Contagious: Spreads quickly though physical contact
-Can be sexually transmitted
Scabies: Symptoms
-Itching
-May see thin burrow tracks from mites
How do proteolytics affect the prostate
Breaks down metabolites of estrogen
What areas are affected by Scabies?
Buttocks, genitals, nipples, arm pits, wrists & between fingers and toes
