Men's Health Flashcards
Psychometric questionnaire for erectile dysfunction
International Index for Erectile Function
Ix for erectile dysfunction
- Measure HbA1c or fasting blood glucose
- lipid profile
- morning testosterone
- repeat testosterone reading and measure FSH, LH and prolactin
- DRE
- BP
- BMI
- External genitalia examination
Priapism
Persistent erection - admit to hospital
Referral
Urology - young men with difficulty obtaining or maintain erection
Endocrinology - hypogonadism
Cardiology - severe CVD
Mental health services
Mx of erectile dysfunction
Sildenafil
Lifestyle advice
Causes of erectile dysfunction
Vasculogenic - CVD, DM, smoking etc.
Neurogenic central — degenerative disorders (such as multiple sclerosis, Parkinson’s disease, and stroke,
Neurogenic (peripheral) — diabetes mellitus, chronic renal failure
Anatomical or structural — penile cancer, prostate cancer, congenital curvature of the penis, micropenis, hypospadias, epispadias, phimosis.
Hormonal — hypogonadism, hyperprolactinaemia, Cushing’s disease
Psychogenic
Drugs associated with erectile dysfunction
Antihypertensives — beta-blockers, verapamil
Diuretics — spironolactone and thiazides.
Antidepressants — tricyclics, monoamine oxidase inhibitors, SSRI
Antiarrhythmic drugs — digoxin, amiodarone.
Antipsychotics - haloperidol.
Hormones and hormone-modifying drugs — 5-alpha reductase inhibitors - finasteride
Recreational drugs
Psychogenic cause of ED
Generalised anxiety
Situation anxiety
Prostatitis
(UTI): Dysuria, frequency, urgency.
Prostatitis:
Perineal, penile, or rectal pain.
Acute urinary retention, obstructive voiding symptoms
Low back pain, pain on ejaculation.
Tender, swollen, warm prostate (on gentle rectal examination).
Bacteraemia:
Rigors, arthralgia, or myalgia.
Fever, tachycardia.
Ix for prostatitis
Mid stream urine sample to confirm UTI
Blood cultures and FBC
DRE
Urgent referral for prostatitis
Immunocompromised or has diabetes mellitus.
Pre-existing urological condition (such as benign prostatic hypertrophy or an indwelling catheter)
Mx if prostatitis
Ciprofloxacin - 14 days then review
Paracetamol
Fluids