Mens Health Flashcards
danger signal:
Priapsm
Male complains of a prolonged and painful erection for several hours (≥2–4 hours) that is not associated with sexual stimulation or desire
-ED
danger signal:
Paraphimosis
Paraphimosis is when the foreskin cannot be returned back to its original position because of swelling of the head (glans) of the penis
-t requires emergency treatment because it may cause ischemic changes.
danger signal:
Testicular Cancer
Teenage to young adult male complains of nodule, sensation of heaviness or aching, one larger testicle
-new onset of a hydrocele
-More common in White males aged 15 to 30 years
danger signal:
Prostate Cancer
DRE findings
what further testing would you do?
Older to elderly man complains of a new onset of low-back pain and rectal area/perineal pain or discomfort
-weaker stream and nocturia
DRE findings
-firm
-fixed
-asymmetric
-**Painless
what further testing would you do?
-PSA
- >4 = probable cancer
-then Refer
danger signal:
Torsion of the Appendix Testis (Blue Dot Sign)
abrupt onset of a blue-colored round mass located on the testicular surface
-The blue dot is caused by infarction and necrosis of the appendix testis due to torsion.
-***Cremasteric reflex IS present, not testicular torsion.
-Most cases occur in children aged 7 to 14 years
danger signal:
Fournier’s Gangrene
rapidly progressing polymicrobial necrotizing fasciitis of the external genitalia and the perineum
-abrupt onset of severe pain, redness, and swelling of the skin in the perineum.
-It spreads rapidly, and the skin will turn black (gangrene).
-Can include the scrotum and penis or the labia in females.
-Considered a surgical emergency; requires surgical debridement and intravenous (IV) antibiotics.
-DM increases risk
Finasteride (Proscar)
used for:
how it works:
keep in mind:
“antiandrogen”
used for:
-prostate cancer
how it works:
-shrinks prostate temporarily while in use
-shrinks 50% –> so PSA must be doubled (X2)
keep in mind:
-if pt stops taking Proscar, the prostate gland returns back to original size
-category X drug. Preggos CANNOT touch with bare hands.
exam tip:
Pt with BPH and HTN, what drugs to try first?
-terazosin (Hytrin)
-doxazosin (Cardura)
Peyronie’s Disease
An inflammatory and localized disorder of the penis that results in fibrotic plaques on the tunica albuginea.
Results in penile pain that primarily occurs during erection; palpable nodules and penile deformity (crooked penile erections) occur.
-scar tissue from injury
-PAINFUL ERRECTION
“PAY RONIE’S hooker more… his thingy is curved”
Balanitis
see this in
Candidal infection of the glans penis
-Treated with topical over-the-counter (OTC) azole creams such as clotrimazole 1% or miconazole 2% (topical anti-fungal)
see this in:
-uncircumcised
-poor hygiene
-diabetics
“losing BALANce- the tip of my peen is so heavy”
Exam Tip:
Chronic prostatitis vs Acute prostatitis
Chronic prostatitis
-gradual onset (>6 wks)
-prostate can feel normal w/DRE
-older males
Acute prostatitis
-sudden onset
-prostate is swollen and very tender
-younger males
Physiologic phimosis is seen in almost all newborn males and
is considered normal
Pathologic phimosis is
when the foreskin is truly nonretractable.
- Refer to urologist
Paraphimosis
is when the foreskin cannot be returned back to its original position because of swelling of the head (glans) of the penis
-Paraphimosis is considered a urologic emergency. Refer to ED
Spermatocele
A spermatocele (or epididymal cyst) is a fluid-filled cyst that contains nonviable sperm (Figure 4).
It will transilluminate because it is filled with fluid.
It can be palpated as a separate smooth and firm lump at the head of the epididymis, which lies above and behind each testicle.
Spermatoceles do not affect fertility. They are treated only if they cause pain, discomfort, or embarrassment (surgical excision).
An ultrasound is the imaging test of choice
Varicocele
Varicose veins in scrotal sac (feels like “bag of worms”; Figure 2).
-New-onset varicocele can signal testicular tumor (20%) or a mass that is impeding venous drainage.
-Order an ultrasound of the scrotum.
-Most benign varicoceles are left sided.
Unilateral right-sided varicoceles may be indicative of a tumor inside the chest, abdomen, or pelvis that is compressing a large vein, such as the vena cava.
-Another abnormal finding is a varicocele that does not reduce (or drain) in the supine position.
-Benign varicoceles reduce in volume when the patient is supine due to the blood draining (gravity) from the abnormally dilated scrotal veins
