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Urology > Penile & Urethral Disorders > Flashcards

Penile & Urethral Disorders Flashcards

1
Q

Disorders of the Urethra

A

Urethritis
Urethral stricture
Meatal stenosis
Hypospadius

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2
Q

Define Urethritis

A

Inflammation of the urethra

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3
Q

Causes of Urethritis

A 
Gonorrhea
Chlamydia
HPV
Herpes simplex
Idiopathic
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4
Q

Symptoms of Urethritis in Males

A

Dysuria
Itching or burning at the meatus
Hematuria/hematospermia
Urethral discharge

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5
Q

Symptoms of Urethritis in Females

A

Frequency
Dysuria
Suprapubic discomfort
Discharge

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6
Q

Diagnostics of Urethritis

A

UA & culture

NAATs

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7
Q

Treatment of Urethritis

A

Azithromycin
Doxycycline
Alternatives: erythromycin, levofloxacin/cipro
Treat partner
Use condoms
Avoid irritants: caffeine, citric juices, tomatoes
NSAIDs

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8
Q

Define Urethral Stricture

A

Narrowing of the urethra with slowing of the urine

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9
Q

Two Types of Urethral Stricture

A

Anterior: begins at the bulbar urethra & end at the meatus
Posterior: involves the membranous & prostatic urethra

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10
Q

Etiology of a Urethral Stricture

A

Trauma
Iatrogenic
Infection

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11
Q

Trauma Etiology of Anterior Urethral Stricture

A

Straddle injuries

Penetrating injuries

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12
Q

Trauma Etiology of Posterior Urethra

A

Urethral disruption from pelvic fracture

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13
Q

Iatrogenic Etiology of Urethral Stricture

A

Catheterization

Surgical

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14
Q

Infectious Etiology of Urethral Stricture

A

Gonococcal

Chlamydia

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15
Q

Presentation of Urethral Strictures

A

Slow stream
Decreased caliber
Post-void dribbling

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16
Q

Diagnosis of Urethral Strictures

A

Catheter
Cystoscopy
Retrograde urethrogram (RUG)

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17
Q

Treatment of Urethral Stricture

A

Urethral dilation
Direct vision intra-uthrotomy (DVIU)
Urethroplasty

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18
Q

Define Meatal Stenosis

A

Narrowing of the opening of the urethra at the tip of the penis

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19
Q

Causes of Meatal Stenosis

A

Swelling & irritation after newborn circumcision

Idiopathy

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20
Q

Symptoms of Meatal Stenosis

A

Spraying of stream
Bed wetting
Dysuria

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21
Q

Diagnosis of Meatal Stenosis

A

Physical exam

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22
Q

Treatment of Meatal Stenosis

A

Meatonomy

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23
Q

Define Hypospadius

A

Congenital defect in which the opening of the urethra is on the underside of the penis

24
Q

Presentation of Hypospadius

A

Spraying of urine
Having to sit down to void
Foreskin makes the penis look like it has a “hood”

25
Q

Diagnosis of Hypospadius

A

Made at the time of birth with PE

26
Q

Treatment of Hypospadius

A

Surgical repair (4-18 months)

27
Q

Complications of Surgical Repair of a Hypospadius

A

Meatal stenosis

Fistula

28
Q

Penile Disorders

A 
Balanitis
Phimosis
Paraphimosis
Peyronie's Disease
Erectile Dysfunction
29
Q

Define Balanitis

A

Inflammation of the glans penis

Uncircumcised men with poor hygiene most affected

30
Q

Causes of Balanitis

A

Infectious: candida, chlamydia, pseudomonas, gonorrhea

Non-infectious: balanitis xerotica obliterans

31
Q

Presentation of Balanitis

A

Pain
Irritation
Itching/Burning

32
Q

PE Findings for Balanitis

A

Erythema/Edema
Discharge
Ulceration

33
Q

Diagnosis of Balanitis

A

Culture discharge
Wet mount
Potassium hydroxide

34
Q

Treatment of Balanitis

A

Retraction of foreskin/wash with soap & water
Bacitracin if bacterial infection suspected
Topical clotrimazole for candidal infection
Circumcision

35
Q

Define Phimosis

A

Inability to retract the foreskin over the glans due to narrowing constriction, or adhesions

36
Q

Causes of Phimosis

A

Balanitis

Poor hygiene

37
Q

Complications of Phimosis

A

Balanitis
Paraphimosis
Voiding problems
Penile carcinoma

38
Q

Presentation of Phimosis

A

Erythema
Itching
Discharge
Pain with erection & intercourse

39
Q

Treatment of Phimosis

A

Betamethasone cream 0.05% BID

Circumcision

40
Q

Define Paraphimosis

A

Retracted foreskin becoming trapped proximal to the glans resulting in edema, inflammation, and pain

41
Q

Treatment of Paraphimosis

A

Firm compression & manual reduction of the foreskin

Circumcision

42
Q

Define Peyronie’s Disease

A

Curvature of the penis, particularly during erections

Fibrosis & plaque formation of the tunica albuginea

43
Q

Causes of Peyronie’s Disease

A

Vascular trauma

Injury to the penis

44
Q

Acute Phase of Peyronie’s Disease

A

First 18-24 hours

Includes penile pain, some curvature, penile nodule, & inflammation

45
Q

Chronic Phase of Peyronie’s Disease

A

Characterized by stable plaque, penile angulation, & loss of erectile ability

46
Q

Presentation of Peyronie’s Disease

A 
Penile pain
Penile angulation
palpable plaque
Indentation in the shaft
Decreased erectile dysfunction
47
Q

Treatment of Peyronie’s Disease if Diagnosed in the First 6 Months

A

Vitamin E
Ibuprofen
Colchicine

48
Q

Treatment of Peyronie’s Disease if Diagnosed After 6 Months with a Stable Plaque

A

Injection therapy

Surgery

49
Q

Injection Therapy for Peyronie’s Disease

A

Collagenase clostridiu histoyticum (Xiaflex)

Verapamil: breaks up scar tissue

50
Q

Define Erectile Dysfunction

A

Inability to achieve or maintain an erection for satisfactory sexual performance

51
Q

Risk Factors for Erectile Dysfunctino

A 
HTN
Smoking
DM
Hyperlipidemia
Obesity
Surgery: prostatectomy, lymph node dissection
Meds: SSRIs, beta-blockers
52
Q

Diagnosis of Erectile Dysfunction

A 
International index of erectile function questionnaire
Fasting glucose
Lipid panel
TSH
Testosterone level
53
Q

Treatment of Erectile Dysfunction

A

1st: lifestyle modifications
1st-line medications: phosphodiesterase type 5 inhibitors
2nd-line medications: alprostadil (Caverject), vacuum pump device, Muse intraurethrally
3rd-line: inflatable penile prosthesis

54
Q

Phosphodiesterase type 5 (PDE5) Inhibitors for Erectile Dysfunction

A

Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Avanafil (Stendra)

55
Q

SE of Phosphodiesterase Type 5 (PDE5) Inhibitors

A

Headache
Flushing
Rhinitis
Abnormal vision

Urology (12 decks)

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