The Penis Flashcards
__ is inflammation of the glans penis or penile foreskin (red rocket ship)
Balanitis/posthitis
What is the etiology of Balanitis/posthitis?
Yeast (usually in poorly controlled DM pts)
What is the presentation and S/s of Balanitis/posthitis?
Glossy flat lesions of penis/foreskin
Blotchy erythema
Adhesions
Smegma; phimosis
What are options for tx of Balanitis/posthitis?
Lotrimin
(+/-) limited course of mild topical steroid
Control DM
Proper hygiene
___ is the inability to retract foreskin
Phimosis
What are causes of Phimosis
Physiologic→ normal through 4 y/o
Pathologic→ usually feature of poor DM control in adult w/ monilial (yeast) posthitis; rarely traumatic
What are the s/s of Phimosis
Penile pain fissuring of foreskin deflection w/ erection associated UTI associated urinary retention
____ occurs when the foreskin is stuck in retracted position, cannot be reduced
Paraphimosis
What is the etiology for Paraphimosis
Iatrogenic→ frequent feature of poor catheter care [most common]
What are the s/s of paraphimosis
What is a potential complication?
Edema/ redness/pain
Glans can potentially be compromised
What are the 2 tx options for paraphimosis?
Manual compression/reduction
Dorsal slit (incise the foreskin in the OR) (like a hot dog wrapped up in a crescent roll)
o(((((((3
___ is inflammation of the urethra
Urethritis
What is the etiology of urethritis?
STI (usually gonococcal, chlamydial)
What are the S/s of Urethritis?
Diffuse purulent discharge w/ dysuria
What is used to dx and tx urethritis?
Dx: urine probe, swab
Tx: Ceftriaxone/Cipro + Azithro/Doxy
___ is the inability to obtain/maintain erection
ED
What is the etiology for ED?
Vasculogenic (poor arterial inflow; veno-occlusive etiologies)
Neurogenic/psychogenic
Rx ADRs (psychotropics, antihypertensives)
Hormonal
What are some RF for ED?
DM HTN CAD HLD Smoker
Options for tx of ED?
PDE inhibitors (Viagra, Levitra, Cialis)
Injectable PGE1 (Caverject)
Penile PGE1 suppository (MUSE)
Vacuum erectile device
Surgery
What is a penile condyloma?
Penile warts (ew!)
What is the etiology for penile condyloma?
HPV
What are the S/s of penile condyloma?
Bulky, solitary/multiple warts
How is the dx for penile condyloma made? When should you bx a wart?
Clinically
Bx if atypical features, refractory to tx, and/or immunocompromised
What is the tx for a penile condyloma?
Destruction: podofilox, cryotherapy
Immune rx: veregen, imiquimod
Surgical
What are some counseling tips for pts w/ penile condyloma?
No cure
Tell partner (hey baby you got warts)
Use condoms
Associated w/ other STIs
Penile CA is (common/rare)
Rare
What are common etiologies for Penile CA?
HPV: 16, 18, 31, 33
Who is less likely to get penile CA? (Circumcised or Uncircumcised pts)
Circumcised –> it is a squamous skin CA
What are the S/s of penile CA
Condylomata
Penile swelling
Balanitis
Phimosis
What are some prevention steps pts can take to reduce their risk of penile CA?
HPV vaccine; maybe circumcision
Are urethral strictures congenital or iatrogenic?
BOTH!
What is the tx for urethral strictures ?
Dilation
Internal urethrotomy
Urethroplasty
