Men's Health

Question 1

Hydrocele - adult

Answer 1

Tip: Consider testicular cancer in a young man presenting with a hydrocele
Investigation: Needs ultrasound

Question 2

Priapism (key points, causes)

Answer 2

Key point:
● Medical emergency
● Delayed treatment can cause permanent damage
● If an erection has lasted more than 2 hours, advise for: cold shower, go for a gentle jog, phone the treating practitioner or after hours number
● Intracavernosal therapy is the most common cause of priapism

Causes:

• idiopathic
• haematological (sickle cell, leukaemia)
• tumours (metastatic cancer)

Question 3

47M, recently prescribed sildenafil for erectile dysfunction, has taken 100mg for the first time. Calling practice for
emergency advice due to painful erection that has been going on for 2 hours. Has smoked marijuana.

1. What are two possible measures you would advise him to try at this stage?
2. Patient does not respond to the advised home treatment options. After further phone discussion he presents to the
   emergency department where you work as a GP in a rural hospital. What are 3 features of your management at this
   stage?
3. What are 2 possible complications of priapism which may happen with delayed treatment?

Answer 3

What are two possible measures you would advise him to try at this stage?
● Cold shower
● Taking oral pseudoephedrine 120mg
● Walking up and down stairs/gentle

Patient does not respond to the advised home treatment options. After further phone discussion he presents to the emergency department where you work as a GP in a rural hospital. What are 3 features of your management at this
stage?
● Request urgent input from urology team at the closest tertiary hospital
● Corporal aspiration
● Intracavernous injection of phenylephrine

What are 2 possible complications of priapism which may happen with delayed treatment?
● Erectile dysfunction
● Disfigurement of the penis