Penile Disorders Flashcards
What histological type of cancer is penile cancer?
Squamous cell carcinoma
What is the typical demographic of individual to be affected by penile cancer?
Older, uncircumcised men (particularly in developing countries)
The differentiated type of penile cancer is usually a result of what?
Chronic inflammation
The undifferentiated type of penile cancer is usually a result of what?
HPV type 16/18 infection
How does squamous cell carcinoma in situ present on the penis?
Red, velvety plaques
What is squamous cell carcinoma in situ known as if it is located on the glans, foreskin or shaft of the penis?
Erythroplasia of Queyrat
What is squamous cell carcinoma in situ known as if it is located on any part of the male genitalia apart from the glans, foreskin or shaft of the penis?
Bowen’s disease
Other than squamous cell carcinoma in situ, what is another pre-cancerous lesion of the penis?
BXO (lichen sclerosus)
How can pre-cancerous lesions of the penis usually be treated?
Circumcision
Penile cancer tends to spread to which lymph nodes?
Inguinal
How do penile cancers tend to present?
Ulcerating lesions on the glans or foreskin, which may be associated with pain and a foul smelling discharge
How are early cases of penile cancer treated?
Radiotherapy and irridium wires
How are late cases of penile cancer treated?
Amputation and lymph node dissection
What are the two most common causative organisms of urethritis?
Neisseriae gonorrhoeae and chlamydia trachomatis
How does urethritis typically present in men?
Purulent urethral discharge
What is balanitis?
Inflammation of the foreskin and glans penis
What cause of balanitis typically occurs after intercourse, and is associated with itching and a white non-urethral discharge? How should this be treated?
Candida - topical clotrimazole
What cause of balanitis is usually painful and can be itchy with a yellow non-urethral discharge? How should this be treated?
Bacterial - oral flucloxacillin
What cause of balanitis is associated with the presence of Wickham’s striae and violaceous papules? How should this be treated?
Lichen planus - high potency topical steroids e.g. clobetasol
How should balanitis caused by dermatitis be treated?
Low potency topical steroids e.g. hydrocortisone
What cause of balanitis is associated with the formation of white plaques and may cause significant scarring? How should this be treated?
Lichen sclerosus (BXO) - circumcision
What is meant by the term phimosis?
The foreskin cannot be retracted
In adults, phimosis is associated with what condition?
BXO
What is meant by the term paraphimosis?
The foreskin cannot be pulled forwards over the tip of the penis
What is the risk of paraphimosis- why is it a urological emergency?
It prevents venous return and risk ischaemia of the glans penis
What are some management options to try to relieve paraphimosis?
Manual compression of the glans penis, 50% glucose soaked swab, ice packs, lidocaine gel
What surgical options are available to treat paraphimosis if conservative management fails?
Aspiration, dorsal slit, circumcision
What is meant by the term priapism?
A persistent erection lasting > 4 hours
Priapism can be high flow or low flow- which type is typically associated with penile trauma?
High flow
Priapism can be high flow or low flow- which type is more common?
Low flow
Priapism can be high flow or low flow- which type is painful?
Low flow
How can you distinguish between high or low flow priapism?
Aspiration of the corpus cavernosa
How is low flow priapism treated?
Aspiration
What is Fournier’s gangrene?
Necrotising fasciitis occurring around the male genitalia
How is Fournier’s gangrene managed?
Antibiotics and surgical debridement
What are some commonly prescribed drugs which may cause erectile dysfunction as side effects?
SSRIs, thiazide diuretics, beta blockers
What class of drug is most commonly prescribed for erectile dysfunction?
Phosphodiesterase-5 inhibitors
