Sexual problems - male Flashcards
What is Pegronie’s disease?
formation of scar tissue in form of fibrous plaque inside tunica albicans of penis resulting in bent, erect penis = pain in erectile dysfunction
What can cause Pegronie’s disease?
trauma
genetic predisposition
How do you treat Peyronie’s disease?
pentoxifylline
verapamil or collagenase injection
tissue graft, removal or prosthesis as last resort
Mild - don’t treat
What is hypospadius?
Congenital disorder where urinary opening of urethral is not in normal place at head of the penis
How do you treat hypospadius?
surgery in childhood
What is anejaculation?
Inability to ejaculate semen despite stimaulation of penis
What are the different categories ofanejaculation?
situation or total
total - aneorgasmic, orgasmic
Name 3 causes of anejaculation
spinal cord injury hormonal therapy for prostate cancer MS low serum testosterone post pelvic surgery psychotrophic medications
Name some causes of ejectile dysfunction
chronic medical conditions
hormonal disorders
latrogenic
age-related
Name treatments of erectile dysfunction
Viagra
injectable or intraurethral alprostad
mechanical treatment e.g. vacuum, kegel
How would you treat male hypoactive sexual desire disorder?
psychosexual therapy CBT psychodynamic systemic testosterone replacement - repeat tests first, test TSA first
Name 3 causes of rapid ejaculation
genetic susceptibility
hyperthyroid
comorbid sexual problems
prostatis
Name 3 treatments of rapid ejaculation
local topical anaesthetic - stud 100
dapoxetine
therapy
Behavioural interventions - Kegel exercises, stop-and-start technique, squeeze
Name 3 causes of retrograde ejaculation
prostate or bladder neck surgery SSRIs alpha blockers Diabetes MS PD spinal cord injury
When could you treat retrograde ejactulation?
To aid fertility
How could you treat retrograde ejaculation?
e.g. ephedrine - keep external and internal sphincters closed during ejaculation but increased BP and HR
How do you test for retrograde ejaculation?
urine dip for spermatozoa and fructose
Name 3 causes for delayed ejaculation
congenital trauma surgery depression age infectious disease
Name tests delayed ejaculation
physical
bloods - PSA, BM, B12, folate, tetstosterone, FBC
Name treatment for delayed ejaculation
personal sexual therapy
Kegel
vibration/superstimulation
What is aspermia?
lack of semen with ejaculate
Name 3 causes of aspermia?
prostate or bladder surgery
retrograde ejaculation
androgen deficiency
MS, PD, DM, STI, UTI
