Patho - Disorders of the Male Reproductive System

Question 1

what is hypospadias?

Answer 1

-Urethral meatus located on lower (ventral) aspect of the penis.
-Developmental anomaly during embryological development: incomplete fusion of urethral folds.
-Surgical repair.

Question 2

what is epispadias?

Answer 2

-Urethral meatus located on upper (dorsal) aspect of penis.
-Developmental anomaly during embryological development

Question 3

what is Priapism? etiology? treatment?

Answer 3

painful, persistent erection d/t engorgement with blood.
Etiology: Idiopathic causes; sickle cell anemia, anticoagulant tx, diabetes, leukemia, use of antidepressants
Tx: Treat underlying cause, aspiration of blood, injection of α-adrenergic agents.

Question 4

what is phimosis? etiology? pathogenesis?treatment?

Answer 4

foreskin of the penis is too tight to be pulled back over the head of the penis
Etiology: Chronic inflammation & infection from poor hygiene
Patho: Uncircumcised foreskin cannot be retracted over glans of penis. Squamous cell CA may occur.
Tx: Tx infection

Question 5

what is erectile dysfunction?

Answer 5

-Inability to achieve or maintain erection sufficient for satisfactory sexual performance
-Primary -Inability to attain an erection throughout life
-Secondary-No longer able to attain erection, but normal in past

Question 6

secondary etiologies of erectile dysfunction

Answer 6

-PVD: arterial insufficiency, atherosclerosis, stenosis of arteries
-Endocrine: DM, pituitary dysfunction
-Rx´s: antihypertensives, antihistamines, phenothiazines, some antidepressants
-Trauma: penile fractures
-Iatrogenic causes: Vascular surgery, radical pelvic cancer surgery
-Psychological causes

Question 7

what is cryptorchidism?

Answer 7

undescended testicle
-“Hidden testes”: testes incompletely descended or external to canal.
-May effect spermatogenesis & cause infertility.
-Undescended testicle usually located in inguinal canal.
-↑ Incidence of malignancy if untreated

Question 8

cryptorchidism etiology

Answer 8

-Idiopathic
-Intrinsic testicular defect
-Hormonal deficiency
-Prematurity
-Low birth weight
-Family hx

Question 9

what causes Hypogonadism? diagnosis? treatment?

Answer 9

-Cause: primary testicular failure
-Androgen deficiency in aging male
-Causes erectile dysfunction (ED), loss of muscle tone, osteoporosis & lipid changes

Dx: serum testosterone level

Tx: replace testosterone

Question 10

what is hydrocele? treatment?

Answer 10

-Fluid collection surrounding testicle or spermatic cord.
-Scrotal swelling; varies in size.
-Two types; communicating & non-communicating.
-Develops secondary to injury, radiation, infxn or neoplasm’s.

Tx—surgical drainage

Question 11

what is spermatocele?

Answer 11

Painless cystic masses containing sperm—may be large and difficult to distinguish from a hydrocele.
Idiopathic

Question 12

what is testicular torsion?

Answer 12

-Twisting of spermatic cord with compromise of testicular vascular supply with ischemia & infarction.
-Sudden, severe pain & swelling.
-Considered a medical emergency.

Question 13

what is epididymitis?

Answer 13

Inflammation of epididymis

Question 14

epididymitis etiology

Answer 14

STD’s (N. gonorrhoeae or C. Trachomatis), trauma or reflux.
-Inflammation of testes from trauma, reflux of sterile urine up vas deferens or secondary to bacterial infection

Question 15

epididymitis CM

Answer 15

-Enlarged, reddened, tender scrotum
-Pain with radiation into inguinal area
-Elevated WBC and urine positive for organism
-Pain
-Fever
-Urethral discharge

Question 16

what is benign prostatic hyperplasia?

Answer 16

Benign enlargement of prostate gland d/t hyperplasia or hypertrophy

Question 17

benign prostatic hyperplasia etiology

Answer 17

Idiopathic, aging male endocrine system

Question 18

benign prostatic hyperplasia pathogenesis

Answer 18

-Result of decreased testosterone & increased estrogen levels.
-Hyperplasia (prostate cells) of glands surrounding the urethra.
-Compression of urethra produces symptoms of bladder obstruction.

Question 19

benign prostatic hyperplasia CM

Answer 19

-Decrease force of stream
-Hesitancy
-Incomplete bladder emptying
-Infection d/t residual urine
-Nocturia
-Dribbling
-Feeling of full bladder

Question 20

what is prostatitis?

Answer 20

-Inflammation of prostate.
-4 types: acute & chronic bacterial, nonbacterial, prostatodynia.

Question 21

prostatitis etiology

Answer 21

E. Coli, Proteus
& Klebsiella.

Question 22

prostatitis CM

Answer 22

-Frequency, urgency & dysuria
-Rectal exam (DRE): tender, swollen prostate
-Acute: Fever, chills, LBP
-Chronic: Voiding symptoms with pain in perineum, back, suprapubic & occasionally testis

Question 23

what is prostate cancer?

Answer 23

Slow growing, asymptomatic in early stages.
-3rd leading cause of -CA death in men
Rare in men younger than 50

Question 24

prostate cancer etiology

Answer 24

unknown
-Contributing factors: genetic, hormonal, dietary, viral

Question 25

types of prostate cancer

Answer 25

Stage 1: microscopic & intracapsular.
Stage 2: tumor palpable on DRE but confined to prostate.
Stage 3: tumor has extended beyond capsule of the prostate.
Stage 4: Involve adjacent structures

Question 26

prostate cancer CM

Answer 26

-Enlarged prostate
-Urinary symptoms
-Elevated PSA
-Back pain
-Weight loss
-Fatigue
-May be asymptomatic

Question 27

prostate cancer treatment

Answer 27

-Watchful waiting
-Radical prostatectomy
-Hormone therapy (to reduce androgens)
-Radiation therapy
-Cryotherapy
-Lymph node removal
-Tx depends on staging & patient’s age