Men's Health

Question 1

Risk factors for Prostate cancer

Answer 1

age
FHx prostate or breast cancer
obesity

Question 2

Symptoms of prostate cancer

Answer 2

difficulties with urination
blood in urine or semen
Pain during sex/orgasm

Question 3

Detection of prostate cancer involves

Answer 3

digital rectal examination
biopsy
PSA testing

Question 4

5 approaches to prostate cancer management

Answer 4

watchful waiting
active surveillance

Surgical approaches
- removal of prostate gland (open vs lap)
TURP

Radiotherapy
Hormone therapy

Question 5

Surgical approaches for prostate cancer management

Answer 5

radical prostatectomy for stage 1-2 cancers
-removal of entire prostate gland, surrounding tissues, seminal vessels

open removal

laparoscopic

Question 6

Open surgical approaches for removal of prostate cancer include

Answer 6

radical retropubic
and
radical perineal

Question 7

Radical retropubic surgery

Answer 7

lower abdo incision under GA/Spinal

lymph node resection if local spread/LNB

Question 8

Radical perineal surgery

Answer 8

surgical incision between the anus and perineum
less common due to increase risk of side effects
unable to access LNs
Shorter operation, less painful
urinary catherisation

Question 9

Laparoscopic surgical approaches - advantages over open surgery

Answer 9

small incision 
decreased blood loss
decreased post surg pain
faster recovery 
decreased length of stay 

still requires catherisation
similar rates of erectile dysfunction, incontinence for open prostatectomy

Question 10

list 4 surgery risk

Answer 10

standard risks for surgery

highly vascularised area
near abdominal structures
development of a lymphocele

Question 11

surgical side effects include

Answer 11

urinary incontinence 
impotence 
loss of fertility 
lymphedema 
decrease in length 
inguinal hernia

Question 12

side effects of TURP

Answer 12

post op bleeding 
retrograde ejaculation 
ongoing urinary problems 
Erectile dysfunction 
infertility

Question 13

Post operative mgmt includes

Answer 13

deep breathing
supported cough
circulatory exercises
pelvic floor exercises

Question 14

post op education includes

Answer 14

no lifting>5kg for four weeks
light lifting 10-12 wk post op 
avoid repetitive movements 4-6wks 
avoid jarring activities 12 weeks
surgeon will direct return to driving/work 
Best post op exercise -walking???

Question 15

When to start PFE

Answer 15

ideally pre op

start post op once catheter is removed

progress to TAB co-activation

Question 16

good dietary habits include

Answer 16

aim to drink 1.5-2L fluid
increase fluids if hot weather or exercising
cut out caffeine, alcohol, fizzy, sugary drinks

high fibre diet- wholegrain/multigrain, cereals, fruits, veges, legumes, nuts/seeds

Question 17

Education for fitness and lifestyle

Answer 17

maintain healthy weight (BMI <25) 
Stop smoking
address chronic cough
aim 30min day of exercise 
do PFE regularly

Question 18

Education for good toilet habits

Answer 18

not just in case weeing

avoid straining

address any UTI

empty your bowels when you feel an urge

contract your PF to try and minimise urge during triggers

Question 19

Bladder diary to calculate

Answer 19

intake vs output

type of incontinence
how often going to the toilet
how often leaking

Question 20

Defecation position

Answer 20

regular BM, avoid constipation and straining
adequate fluid , fibre, exercise

leaning forward and put elbows on knee
knees higher than hips
straighten spine
bulge out abdomen