Penile and Urethral Disorders Flashcards
1
Q
What is the corpus cavernosum? Corpus spongiosum?
A
- corpus cavernosum: 2 columns of tissue that run along side of penis that helps w/ erections
- corpus spongiosum: column of sponge like tissue that runs along front and ending at glans, urethra runs through the spongiosum
2
Q
What is urethritis? Causes?
A
- an inflammation of the urethra
- females greater than males
- Causes:
gonorrhea
chlamydia
HPV
herpes simplex
idiopathic
3
Q
Sxs of urethritis in males and females?
A
- males: dysuria itching or burning at the meatus hematuria/hematospermia urethral d/c
- females: frequency dysuria SP discomfort d/c
4
Q
Dx and tx of urethritis?
A
- dx:
UA and culture
NAATs
-tx: azithro 1 g PO single dose doxy 100mg bidx 7 days - alt: erythromycin 500mg PO qidx 7days levofloxacin/cipro 500 mg once dailyx 7 days - tx partner - use condoms avoid irritants - NSAIDs - avoid acidic foods
5
Q
What is a urethral stricture?
A
- a fibrotic band of tissue that renders the normal compliant urethral lumen inelastic
- narrowing of urethra w/ slowing of urine
- 2 types:
anterior: begins at bulbar urethra and ends at meatus (straddle injuries, falling off of a bike)
posterior: involves membranous and prostatic urethra
6
Q
Etiology of urethral strictures?
A
- trauma:
anterior urethra - straddle injuries, penetrating injuries
posterior urethra - urethral disruption from pelvic fracture - iatrogenic: catheterization, surgical
- infection:
gonococcal/chlamydia
7
Q
Presentation and dx of urethral strictures?
A
- presentation: obstructive urinary sxs - slow stream decreased caliber post-void dribbling - dx: catheter (if able to cath - doesn't have stricture) cystoscopy RUG
8
Q
Tx of urethral stricture?
A
- urethral dilation
- DVIU
- urethroplasty
9
Q
What is a meatal stenosis? Causes? Sxs? dx? Tx?
A
- narrowing of opening of urethra at tip of penis
- more common in males
- Causes:
swelling and irritation after newborn circ, idiopathic - sxs:
spraying of stream
bed wetting
dysuria - dx:
physical exam - Tx:
meatonomy
10
Q
What is hypospadius? How common is this? Presentation?
A
- congenital defect in which opening of urethra is on underside of penis
- 1/300 boys
- 14% siblings
- 8% in offspring
- occurs b/t glands and penile scrotal jxn
- presentation:
spraying of urine
having to sit down to void
foreskin makes penis lool like it has a hood
11
Q
Dx and tx of hypospadius?
A
- dx: made usually at time of birth w/ PE
- tx:
surgical repair (4-18 months)
magpi
snodgrass (complications - meatal stenosis, fistula) - don’t circumcise - need skin to repair
12
Q
What is Balanitis? Causes? Presentation?
A
- inflammation of glans penis
- uncircumcised men w/ poor hygiene most affected
- 3-11% of males
- causes:
infectious
non-infectious - presentation:
pain
irritation
itching/burning
13
Q
PE, dx and tx of balanitis?
A
- PE: erythema/edema D/C ulceration - dx: culture d/c wet mount KOH -tx: retraction of foreskin/wash w/ soap and water bacitracin if bacterial infection suspected - topical clotrimazole for candidal infection - circumcision - especially if recurrent
14
Q
What is Phimosis? Causes? Complications?
A
- inability to retract foreskin over glans due to narrowing, constriction, or adhesions
- in kids phimosis may resolve on own
- 1-5% of male by age of 16
- causes:
balanitis
poor hygiene - complications:
balanitis
paraphimosis
voiding problems
penile carcinoma
15
Q
Presentation and tx of phimosis?
A
- presentation: erythema itching d/c pain w/ erection and intercourse - tx: betamethasone cream 0.05% bid circumcision (alt)
