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PHTH 531 - MEAG > REPRODUCTIVE + URINARY SYSTEMS > Flashcards

REPRODUCTIVE + URINARY SYSTEMS Flashcards

1
Q

what are 4 types of prostatitis/prostatodynia

A
  1. Acute bacterial
  2. Chronic bacterial
  3. Nonbacterial/prostatodynia/CPPS
  4. Asymptomatic inflammatory
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2
Q

Is prostatodynia/CPPS is common or uncommon?

A

common!

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3
Q

What is the presentation of Prostatodynia/CPPS

A
  • 2nd degree pelvic floor dysfunction

- History of sitting increasing pain

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4
Q

What is the presentation of Prostatodynia/CPPS

A
  • 2nd degree pelvic floor dysfunction
  • History of sitting increasing pain
  • Peripheral and central pain sensitization
  • Urinary frequency, urgency, dysuria, nocturia
  • Pain in penis, testicles, perineum
  • Suprapubic pain
  • Painful ejaculation, decreased libido, ED
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5
Q

What is suprapubic pain a sign of

A

Sign of bladder impairment

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6
Q

how is prostatodynia/cpps mANAGED?

A
  • Pain medication (TAD*, anticonvulsants)
  • Alpha blockers
  • Physiotherapy
  • CBT/mindfulness therapy
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7
Q

How is a physio involved with treatment of prostatodynia?

A
  1. Screening
  2. Non mechanical pain onset and pattern, sitting exacerbation, Onset/presence of other pain in urinary genital area
  3. Pelvic floor specific scope
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8
Q

What are common findings that need to be addressed in pelvic floor physio

A
  • Increased pelvic floor resting tone
  • Decreased pelvic floor proprioception
  • Decreased pelvic floor motor control
  • +/- trigger points
  • Sitting (Limit if pain increases)
  • Need pain sensitization education/rx
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9
Q

What is the most effective level of prostate cancer detection and diagnosis

A

PSA SCREENING

  • Protein
  • manufactured in prostate
  • Liquefies the semen
  • Allows sperm to swim freely
  • Dissolves the cervical mucous cap, allowing the entry of sperm
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10
Q

What are normal PSA levels

A

0-0.25 ng per milliliter

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11
Q

Do you need to have elevated PSA levels to have prostate cancer

A

no - can have cancer without elevated levels

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12
Q

What are some causes of false + PSA Levels?

A
  • Prostate infection, UTI
  • Irritation
  • BPH
  • Age
  • Recent ejaculation
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13
Q

What are some complications to radical prostatectomy

A
  • Infection
  • Incontinence (30%)
  • ED (5-30%)
  • Denervation injuries
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14
Q

What are signs and symptoms to screen for for prostate cancer

A
  • Nonmechanical “musculoskeletal”pain
  • night waking
  • men >50
    +/- urology signs and symptoms
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15
Q

what are some side effects of ADT (hormone therapy) as treatment for prostate cancer

A
  • Osteoporosis, fracture

- fatigue, increased body fat, decrease lean body tissue

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16
Q

What are some pelvic floor specific scope things to watch out for with prostatectomy

A
  • Post op incontinence
  • Erectile dysfunction
  • Education
  • Treatment
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17
Q

What are some pelvic floor specific scope things to watch out for with radiation

A
  • Radiation B and B urgency

- Incontinence (2-5yrs after treatment)

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18
Q

___% of men have erectile dysfunction

A

10%

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19
Q

___ men seek medical treatment for ED each year

A

22/1000

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20
Q

disease accounts for ___% of erectile dysfunction

A

70%

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21
Q

Psychological factors account for ___% of erectile dysfunction

A

20%

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22
Q

What is endometrial

A

tissue outside of the uterus

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23
Q

What are risk factors for endometriosis

A
  • Postponed pregnancy
  • Early menarche
  • Shorter cycles (<27 days, longer bleeding)
  • Family history
  • Autoimmune
24
Q

Endometriosis occurs with ____ menstruation

A

retrograde

25
Q

____% of women have endometriosis

A

7-60%

26
Q

___% of infertile women have endometriosis

A

50% q

27
Q

Are the extent of endo lesions an indication of the pain experienced?

A

no

28
Q

What is the etiology of endometriosis

A
  • retrograde menstruation - blood flow up into body rather than out
  • Tissue implants in pelvis and abdomen
  • can implant throughout the body
  • Implants respond to cyclical hormonal changes
  • lesions swell -> stretch and compress organs + nerves
  • Over time create adhesions
29
Q

What does the presentation of endometriosis depend on?

A

the location of implants

30
Q

What are some possible presentations of endometriosis

A
  • Dyspareunia (pain with intercourse)
  • GI pain, cyclical LBP
  • Pain on defecation
  • Groin or suprapubic pain
  • Menorrhagia (heavy periods)
  • Dysmenorrhea (painful periods)
31
Q

How do you get a definitive diagnosis of endometriosis

A

Laparoscopy

32
Q

A laparoscopy allows for a definitive diagnosis and ….

A

treatment! gets rid of adhesions but you get scar tissue. will normally only do two of them

33
Q

What are the goals of the medical management of endometriosis

A

pain relief + fertility!

No cure

34
Q

What are 4 interventions for endometriosis?

A

NSAIDS
Hormones (IUD or OCP)
Laparoscopy
Hysterectomy

35
Q

How do PTS screen for endometriosis

A
  1. Cyclical LBP, hip, groin - non-mechanical
  2. Dyspareunia - thrusting or deep, might not be able to identify pain location
  3. Differential - hip, groin, lb, dyspareunia
36
Q

How can PT contribute to the treatment of Endometriosis

A
  • education
  • pain sensitization
  • pacing and grading to return to activity
  • Pelvic floor specific scope
37
Q

Endometrial carcinoma is the ____ most common cancer in women (ranking)

A

4th

38
Q

What is the presentation of endometrial carcinoma

A
  • Abnormal vaginal bleeding

- metastases - lymph, lung, live, bones of the lower extremity

39
Q

What would be the PT role in the treatment of Endometrial carcinoma

A
  • Post op lymphedema

- Disuse atrophy

40
Q

What is the pelvic floor specific scope for endometrial carcinoma

A
  • Iatrogenic (illness caused by treatment)

- Pelvic organ prolapse

41
Q

What causes cervical cancer

A

HPV infection

42
Q

How is cervical cancer preventable?

A
  • regular screening
  • early intervention
  • HPV vaccination
43
Q

___% of the population acquire HPV infection in their lifetime

A

75%

44
Q

What is the presentation of cervical cancer

A
  • HPV usually asymptomatic
  • Early stage cancer asymptomatic
  • advanced disease: change in menstrual bleeding, pelvic or LBP (uncommon)
45
Q

5 methods of preventing cervical cancer

A
  • Barrier contraceptives
  • Life long monogamous sex
  • Abstinence
  • Vaccine
  • Pap smear
46
Q

What is the PT treatment for cervical cancer

A
  • Post op lymphedema

- Disuse atrophy

47
Q

What is the pelvic floor specific scope for cervical cancer?

A

Pelvic organ prolapse

48
Q

Where does ovarian cancer arise

A

fallopian tube fimbria - not on surface of ovaries

49
Q

ovarian cancer is in __% OF women

A

2%

50
Q

What is the prevention method for women at low risk of ovarian cancer

A

Fallopian tube removal during routine surgery

51
Q

What is the prevention method for women at highrisk of ovarian cancer

A

genetic testing and prophylactic surgery

52
Q

What is the 5 year survival of ovarian cancer if diagnose in situ? diagnosed advanced?

A

90% in situ

70% if diagnosed advanced

53
Q

What are symptoms you can screen for with ovarian cancer

A
  • Abdominal discomfort
  • Pelvic pain or swelling
  • Bloating or intestinal gas
  • Constipation
  • Frequent urination
  • Vaginal bleeding
  • Fatigue
  • Nausea
  • Fever
54
Q

What are the red flags of ovarian cancer

A
  • Gait disturbances
  • Dyspnea
  • Thoracic or shoulder girdle pain
  • Weight loss
  • Fatigue
55
Q

4 types of pelvic organ prolapse

A
  • Cystocele
  • Rectocele
  • Uterine prolapse
  • Enterocele

PHTH 531 - MEAG (2 decks)

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