Pathology of Male Reproductive System Flashcards
What is Hypospadias
congenital anomaly - ventral location of the urethral opening
-androgen mediated
urethral groove forms inappropriately and does not close completely
what does hypospadias lead to
abnormal or poor stream
increased bed wetting, incomplete voiding
spraying of stream
what is Epispadias
urethral opening on the dorsal side of the penis
can lead to incontinence, reflux, UTI
what is phimosis
inability to retract the foreskin
what is paraphimosis
urologic emergency
entrapment of foreskin in the retracted position
what can paraphimosis lead to
tourniquet effect with necrosis of the glans
what is the presentation of paraphimosis
presents with pain, edematous pepuce
shaft will be flaccid
where are the stimulation for eerections
neurally, may be stimulated leading to reflex arc at S2, S4
centrally in hypothalamus (paraventricular nucleus, autonomic control area) - T11, L2
what increases when ach acts directly on vasculature for erections
Nitrous oxide
what is the reason we give men with ED PDE-5 meds
issues with Nitric Oxide - decrease vascular pressure - inhability to compress venous structures
-atherosclerosis
-DM
what is ED a warning sign of
CVD
What is a fibrous deposition within the tunica albuginea of the shaft of the penis
peyronie’s disease
what is an erection lasting longer than 4 hours
priapism
what are causes of priapism
idiopathic
spinal cord trauma
sick cell disease
tumors
infection
trauma
cocaine
medications (trazadone)
is priapism a emergency
yes
what are low flow causes of priapism
decreased venous return
elevated pressure may lead to ischemia (compartment syndrome)
meds, sickle cell
what are high flow causes of priapism
less common
associated with increase arterial inflow not balanced by venous outflow
associated with trauma
less painful
what is the treatment of priapism
phenalepherine after the lido/bicarb block
What is required for growth of prostate
dihydrotesterone (DHT) - metabolite of testosterone
what does BPH increase the risk of
hematuria
UTI
Pyelonephritis
hydroureter
hydronephrosis
what is inflammation of the prostate
prostatitis
what is the most common cause of prostatitis
E. coli - ascending infection
what is the presentation of acute bacterial prostatitis
presents with sxs of enlarged prostate and infection
fever, perineal pain, dysuria, urinary retention, nocturia, dysorgasmia,
can be bacteremia
what is fluid between the parietal layer of tunica vaginalis and visceral layer of tunica vaginalis
hydrocele
what envelops the testsis
tunica vaginalis
what population is hydrocele common in
newborns
what is secondary hydrocele associated with
infection or trauma
what is dilation of pampiniform plexus vessels
varicocele
how is varicocele described
bag of worms
what is the cause of varicocele
poorly functioning valves so that venous back flow is not prevented - pooling
What is inflammation of the epididymis
epididymitis
what is epididymitis most commonly associated
STI
- N.gonorrhoeae
- C. trachomatis
what is the most common pathogen associated with epididymitis in MSM
E.coli, H. flu, TB
what is the presentation of epididymitis
present with scrotal pain/inflammation
typically acute discomfort
+/- pyuria
swelling of epididymis (starts with trail and ascends)
urinary obstruction
what are risks with epididymitis
abscess, infertility, infarction
scarring can leave lasting problems
what is orchitis
inflammation of testes
what is orchitis associated with
bacteremia or direct spread up the urethrae - through prostate - up vas deferens - through eipididymis - testes
what is orchitis classically associated with
mumps
when does orchitis begin after parotitis
3-4 days after
What is testicular torsion
twisting of the testes resulting in rotation and cessation of blood flow from the spermatic cord
urologic emergency
what is lost with testicular torsion
cremasteric reflex
what is the blue dot sign
as testes becomes necrotic, the testicular appendage will necrose - become cyanotic
