Podcast
Questions and Answers
What is the primary complication associated with bilateral cryptorchidism?
What is the primary complication associated with bilateral cryptorchidism?
- Testicular torsion
- Malignancy
- Hormonal imbalance
- Infertility (correct)
At what age should surgery be performed if the testes have not descended?
At what age should surgery be performed if the testes have not descended?
- At any age if non-palpable
- By 3 months
- Before 12 months (correct)
- By 6 months (correct)
What method is recommended for a thorough examination of potentially undescended testes?
What method is recommended for a thorough examination of potentially undescended testes?
- CT scan for imaging
- Ultrasound immediately after birth
- Palpation during initial examination (correct)
- Serum hormone testing
Which statement is true regarding the prevalence of cryptorchidism in infants?
Which statement is true regarding the prevalence of cryptorchidism in infants?
When should an ultrasound be obtained for undescended testes?
When should an ultrasound be obtained for undescended testes?
What is the primary characteristic of Peyronie disease?
What is the primary characteristic of Peyronie disease?
Which of the following can cause Peyronie disease?
Which of the following can cause Peyronie disease?
What symptom is NOT typically associated with Peyronie disease?
What symptom is NOT typically associated with Peyronie disease?
What recommendation does the American Urologic Association make for adolescent patients regarding testicular health?
What recommendation does the American Urologic Association make for adolescent patients regarding testicular health?
Why might a curved erection not be concerning?
Why might a curved erection not be concerning?
What is the most appropriate initial treatment for Peyronie's disease within three months of onset?
What is the most appropriate initial treatment for Peyronie's disease within three months of onset?
When is surgical management indicated for Peyronie's disease?
When is surgical management indicated for Peyronie's disease?
What imaging modality is NOT commonly used to diagnose Peyronie's disease?
What imaging modality is NOT commonly used to diagnose Peyronie's disease?
Which statement about Peyronie's disease curvature is correct?
Which statement about Peyronie's disease curvature is correct?
Which of the following conditions can occur alongside Peyronie's disease?
Which of the following conditions can occur alongside Peyronie's disease?
What is typically revealed in the urinalysis of a patient with acute prostatitis?
What is typically revealed in the urinalysis of a patient with acute prostatitis?
In treating prostatitis in men younger than 35, which antibiotics are typically administered?
In treating prostatitis in men younger than 35, which antibiotics are typically administered?
What is the primary pathogen in epididymitis for men over 35 years old?
What is the primary pathogen in epididymitis for men over 35 years old?
Which sign is associated with a positive Prehn's sign in epididymitis?
Which sign is associated with a positive Prehn's sign in epididymitis?
When treating chronic prostatitis, how long should fluoroquinolones or Bactrim be administered?
When treating chronic prostatitis, how long should fluoroquinolones or Bactrim be administered?
What distinguishes the symptoms of acute epididymitis from testicular torsion?
What distinguishes the symptoms of acute epididymitis from testicular torsion?
For hospitalized patients with severe sepsis indicating prostatitis, which intravenous antibiotic combination may be administered?
For hospitalized patients with severe sepsis indicating prostatitis, which intravenous antibiotic combination may be administered?
What finding on a scrotal ultrasound may suggest testicular torsion?
What finding on a scrotal ultrasound may suggest testicular torsion?
What is the primary purpose of urinalysis in patients suspected of having prostate issues?
What is the primary purpose of urinalysis in patients suspected of having prostate issues?
What is considered a normal PSA level?
What is considered a normal PSA level?
Which medication is considered the most uroselective alpha-blocker for BPH treatment?
Which medication is considered the most uroselective alpha-blocker for BPH treatment?
What potential side effect is associated with alpha-blockers used in BPH treatment?
What potential side effect is associated with alpha-blockers used in BPH treatment?
What is the mechanism by which 5-alpha reductase inhibitors help treat BPH?
What is the mechanism by which 5-alpha reductase inhibitors help treat BPH?
Combination therapy with PDE5 inhibitors and alpha-1 adrenergic blockers is noted for what benefit?
Combination therapy with PDE5 inhibitors and alpha-1 adrenergic blockers is noted for what benefit?
In which situation is surgery indicated for BPH patients?
In which situation is surgery indicated for BPH patients?
What surgical procedure is commonly performed to relieve obstruction caused by BPH?
What surgical procedure is commonly performed to relieve obstruction caused by BPH?
What is the immediate treatment for a patient with suspected epididymitis under 35 years of age with a potential STD etiology?
What is the immediate treatment for a patient with suspected epididymitis under 35 years of age with a potential STD etiology?
Which of the following tests would help differentiate epididymitis from testicular torsion?
Which of the following tests would help differentiate epididymitis from testicular torsion?
What complication can occur if paraphimosis is not addressed promptly?
What complication can occur if paraphimosis is not addressed promptly?
For patients who practice insertive anal intercourse, what is the appropriate antibiotic regimen for suspected epididymitis?
For patients who practice insertive anal intercourse, what is the appropriate antibiotic regimen for suspected epididymitis?
What condition describes the inability to retract the foreskin in adults, often due to scarring or infection?
What condition describes the inability to retract the foreskin in adults, often due to scarring or infection?
What should be done if the foreskin is found retracted after urethral catheterization?
What should be done if the foreskin is found retracted after urethral catheterization?
What might urinalysis and culture reveal in a case of epididymitis?
What might urinalysis and culture reveal in a case of epididymitis?
What is the first medical action to take in a case of paraphimosis?
What is the first medical action to take in a case of paraphimosis?
What is a primary characteristic of Peyronie disease?
What is a primary characteristic of Peyronie disease?
What commonly contributes to the development of Peyronie disease?
What commonly contributes to the development of Peyronie disease?
Which of the following symptoms is NOT typically associated with Peyronie disease?
Which of the following symptoms is NOT typically associated with Peyronie disease?
When should adolescents perform testicular self-examinations according to the guidelines?
When should adolescents perform testicular self-examinations according to the guidelines?
Why might a curved erection not be a cause for concern?
Why might a curved erection not be a cause for concern?
What percentage of male children with bilateral cryptorchidism may experience infertility?
What percentage of male children with bilateral cryptorchidism may experience infertility?
When should a child with non-palpable testes be referred to urology or surgery for evaluation?
When should a child with non-palpable testes be referred to urology or surgery for evaluation?
What is the most common site for cryptorchidism in males?
What is the most common site for cryptorchidism in males?
What complication can arise from undescended testes aside from infertility?
What complication can arise from undescended testes aside from infertility?
What action should be taken if neither of the testes are palpable at birth?
What action should be taken if neither of the testes are palpable at birth?
What is an acceptable management option for men with stable, mild curvature of Peyronie's disease who maintain satisfactory erectile function?
What is an acceptable management option for men with stable, mild curvature of Peyronie's disease who maintain satisfactory erectile function?
Which treatment is recommended within three months of the onset of Peyronie's disease?
Which treatment is recommended within three months of the onset of Peyronie's disease?
Under what condition is surgical management indicated for Peyronie's disease?
Under what condition is surgical management indicated for Peyronie's disease?
What is a common symptom that may occur alongside Peyronie's disease?
What is a common symptom that may occur alongside Peyronie's disease?
Which imaging modality is typically used for diagnosing Peyronie's disease?
Which imaging modality is typically used for diagnosing Peyronie's disease?
What is the primary characteristic of a varicocele as observed in physical examination?
What is the primary characteristic of a varicocele as observed in physical examination?
Which of the following symptoms is NOT typically associated with benign prostatic hyperplasia (BPH)?
Which of the following symptoms is NOT typically associated with benign prostatic hyperplasia (BPH)?
What examination finding is indicative of BPH during a digital rectal exam?
What examination finding is indicative of BPH during a digital rectal exam?
In the management of varicocele, when is surgical intervention likely warranted?
In the management of varicocele, when is surgical intervention likely warranted?
Which factor is least likely to trigger acute urinary retention in men with BPH?
Which factor is least likely to trigger acute urinary retention in men with BPH?
What is the primary action of phosphodiesterase inhibitors like sildenafil citrate?
What is the primary action of phosphodiesterase inhibitors like sildenafil citrate?
What is the recommended time to take sildenafil before sexual intercourse?
What is the recommended time to take sildenafil before sexual intercourse?
What is the risk associated with using phosphodiesterase inhibitors and nitrates together?
What is the risk associated with using phosphodiesterase inhibitors and nitrates together?
In which age group is acute bacterial prostatitis most commonly observed?
In which age group is acute bacterial prostatitis most commonly observed?
What is one of the most common causes of chronic prostatitis in men over 35?
What is one of the most common causes of chronic prostatitis in men over 35?
Which symptom is commonly associated with acute bacterial prostatitis?
Which symptom is commonly associated with acute bacterial prostatitis?
What should NOT be done if acute prostatitis is suspected during a physical examination?
What should NOT be done if acute prostatitis is suspected during a physical examination?
What is a common urinary symptom associated with chronic prostatitis?
What is a common urinary symptom associated with chronic prostatitis?
What is the most common age range for testicular torsion to occur?
What is the most common age range for testicular torsion to occur?
What is the initial diagnostic test for suspected testicular torsion?
What is the initial diagnostic test for suspected testicular torsion?
Which of the following signs is NOT associated with testicular torsion?
Which of the following signs is NOT associated with testicular torsion?
What is the recommended treatment for testicular torsion once diagnosed?
What is the recommended treatment for testicular torsion once diagnosed?
What is the typical resolution timeframe for phimosis in children?
What is the typical resolution timeframe for phimosis in children?
Which condition necessitates treatment for phimosis?
Which condition necessitates treatment for phimosis?
In the case of testicular torsion, which timing of surgical intervention is critical for the best outcomes?
In the case of testicular torsion, which timing of surgical intervention is critical for the best outcomes?
Which of the following complications does not typically require treatment for phimosis?
Which of the following complications does not typically require treatment for phimosis?
Flashcards
Cryptorchidism
Cryptorchidism
Failure of one or both testicles to descend into the scrotum.
Risk of Cryptorchidism
Risk of Cryptorchidism
Higher risk in premature infants (30%) compared to full-term infants (5%).
Cryptorchidism location
Cryptorchidism location
Right testicle is more commonly affected.
Orchiopexy Timeframe
Orchiopexy Timeframe
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Cryptorchidism Complications
Cryptorchidism Complications
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Peyronie Disease
Peyronie Disease
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Cause of Peyronie Disease
Cause of Peyronie Disease
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Symptoms of Peyronie's Disease
Symptoms of Peyronie's Disease
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Penile Variation
Penile Variation
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Testicular Self-Exams
Testicular Self-Exams
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Peyronie's Disease Bend
Peyronie's Disease Bend
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Peyronie's Disease Diagnosis
Peyronie's Disease Diagnosis
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Mild Peyronie's Disease Treatment
Mild Peyronie's Disease Treatment
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Erectile Dysfunction Definition
Erectile Dysfunction Definition
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Erectile Dysfunction Prevalence
Erectile Dysfunction Prevalence
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Prostatitis Symptoms
Prostatitis Symptoms
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Prostatitis Diagnosis
Prostatitis Diagnosis
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Prostatitis Treatment (young)
Prostatitis Treatment (young)
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Prostatitis Treatment (older)
Prostatitis Treatment (older)
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Epididymitis Symptoms
Epididymitis Symptoms
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Epididymitis Cause (young)
Epididymitis Cause (young)
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Epididymitis Cause (older)
Epididymitis Cause (older)
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Epididymitis Differential Diagnosis
Epididymitis Differential Diagnosis
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Epididymitis (<35 years)
Epididymitis (<35 years)
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Epididymitis (>35 years)
Epididymitis (>35 years)
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Epididymitis (Anal Intercourse)
Epididymitis (Anal Intercourse)
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Phimosis
Phimosis
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Paraphimosis
Paraphimosis
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Paraphimosis Treatment (Initial)
Paraphimosis Treatment (Initial)
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Epididymitis Diagnostics
Epididymitis Diagnostics
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Urethral Catheterization and Phimosis
Urethral Catheterization and Phimosis
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BPH (Benign Prostatic Hyperplasia)
BPH (Benign Prostatic Hyperplasia)
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PSA (Prostate Specific Antigen)
PSA (Prostate Specific Antigen)
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Alpha-blockers
Alpha-blockers
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5-alpha reductase inhibitors
5-alpha reductase inhibitors
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PDE5 Inhibitors
PDE5 Inhibitors
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TURP (Transurethral Resection of the Prostate)
TURP (Transurethral Resection of the Prostate)
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Urinary Calculi
Urinary Calculi
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PSA levels < 4
PSA levels < 4
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Peyronie Disease
Peyronie Disease
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Cause of Peyronie Disease
Cause of Peyronie Disease
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Symptoms of Peyronie's Disease
Symptoms of Peyronie's Disease
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Penile Variations
Penile Variations
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Testicular Self-Exams
Testicular Self-Exams
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Peyronie's Disease Bend
Peyronie's Disease Bend
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Mild Peyronie's Disease Treatment
Mild Peyronie's Disease Treatment
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Peyronie's Disease Diagnosis
Peyronie's Disease Diagnosis
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Erectile Dysfunction
Erectile Dysfunction
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Erectile Dysfunction Prevalence
Erectile Dysfunction Prevalence
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Cryptorchidism definition
Cryptorchidism definition
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Cryptorchidism risk
Cryptorchidism risk
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Cryptorchidism location bias
Cryptorchidism location bias
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Orchiopexy timeframe
Orchiopexy timeframe
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Cryptorchidism complications
Cryptorchidism complications
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Varicocele
Varicocele
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BPH (Benign Prostatic Hyperplasia)
BPH (Benign Prostatic Hyperplasia)
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Varicocele Diagnosis
Varicocele Diagnosis
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BPH Symptoms
BPH Symptoms
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BPH Treatment
BPH Treatment
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Atherosclerotic Risk Factors for ED
Atherosclerotic Risk Factors for ED
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First-line ED Treatment
First-line ED Treatment
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Prostatitis Definition
Prostatitis Definition
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Acute Prostatitis Symptoms
Acute Prostatitis Symptoms
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Chronic Prostatitis Symptoms
Chronic Prostatitis Symptoms
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Acute Prostatitis Caution
Acute Prostatitis Caution
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Prostatitis Cause (under 35)
Prostatitis Cause (under 35)
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Prostatitis Cause (over 35)
Prostatitis Cause (over 35)
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Phimosis in children
Phimosis in children
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Testicular torsion
Testicular torsion
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Testicular torsion cause
Testicular torsion cause
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Testicular torsion diagnosis
Testicular torsion diagnosis
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Testicular torsion treatment
Testicular torsion treatment
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Testicular torsion symptoms
Testicular torsion symptoms
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Phimosis treatment
Phimosis treatment
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Testicular torsion emergency time frame
Testicular torsion emergency time frame
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Study Notes
Men's Health
- Presented by C. Hammond, DNP,MSN, FNP-BC, PMHNP-BC
Cryptorchidism
- Cryptorchidism is the failure of testes to descend (one or both)
- Higher risk in premature infants (30%) compared to full-term infants (5%)
- Most commonly affects the right testicle
- Surgery (orchiopexy) is recommended if not descended by 6 months of age and before 12 months
- Complications of untreated cryptorchidism include testicular cancer (in both descended and undescended testes) and infertility (75% in bilateral cases, 50% in unilateral cases).
- Thorough genital exam, including an attempt to "milk" inguinally located testes into the scrotum
- If testes are palpable, re-examine during the next well-child visit
- If not palpable at birth, obtain an ultrasound immediately.
- Undescended testes can be monitored for spontaneous descent in the first 4-6 months of life
- If still non-palpable at 4-6 months, refer to urology/surgery for evaluation and possible orchiopexy
- Specialists should be consulted for absent testes
- Complications include malignancy, subfertility, and testicular torsion.
- Patients should perform monthly testicular self-exams during adolescence.
Peyronie Disease
- Peyronie disease (PD) is a disorder characterized by a buildup of hardened fibrous tissue in the corpus cavernosum.
- Causes pain and curvature of the penis, especially during erection
- Caused by repeated penile injury (sex, physical activity) and genetic susceptibility
- Symptoms include pain, induration, curvature, shortening, and/or sexual dysfunction.
- Diagnosis is typically apparent from patient history and penile examination.
- Various imaging modalities used for diagnosis including ultrasound, plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
- Oral pentoxifylline (vasodilator and anti-inflammatory) is the initial recommended treatment within three months of onset
- Surgical management is indicated for patients with more than 3-month duration, refractory to medical treatment, and with deformity impacting sexual function
- Observation is an appropriate option for men with mild curvature (≤30 degrees) and satisfactory erectile function
Erectile Dysfunction
- Recurring inability to achieve and maintain an erection sufficient for satisfactory sexual performance
- Affects up to half of men in the US between the ages of 40 and 70
- Risk factors include atherosclerosis (e.g., hypertension, smoking, hyperlipidemia, diabetes), medications (that may lower intracavernosal pressure), sickle cell disease, pelvic surgery, perineal trauma, alcohol abuse, and conditions causing hypogonadism/low testosterone (e.g., hypothyroidism).
- Various imaging modalities for diagnosis including a digital rectal examination, CBC, chemistry panel, fasting glucose, lipid profile, serum testosterone, prolactin levels, and thyroid profile
- Nocturnal penile tumescence evaluations helps determine organic vs. psychogenic causes.
- First-line treatment is with phosphodiesterase inhibitors (sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)).
- Treat underlying cause and address atherosclerotic risk factors
Prostatitis
- Inflammation of the prostate gland
- Classified into acute, chronic, asymptomatic inflammatory, and chronic pelvic pain syndrome.
- Causes include ascending urinary tract infections, spread from the rectum, hematogenous spread (rare). May follow catheterization, cystoscopy, or other procedures,
- Acute bacterial prostatitis usually occurs in younger individuals and is a more serious condition
- Symptoms include fever, chills, malaise, frequency, urgency, dysuria, and perineal/low back pain
- Chronic prostatitis commonly occurs in individuals aged 40-70 years
- Diagnosis includes digital rectal examination, urinalysis, urine cultures, prostatic fluid/secretions analysis, ultrasound/CT scan/cystoscopy, blood tests (CBC, blood cultures if needed), and blood urea nitrogen/creatinine levels. Serum prostate-specific antigen (PSA) may be elevated.
- Avoid prostate massage in suspected acute cases due to potential sepsis risk
- Treatment involves (4-6 weeks) fluoroquinolones or Bactrim, or intravenous antibiotics in severe sepsis/bacteremia cases.
Epididymitis
- Inflammation of the epididymis, characterized by dysuria, unilateral scrotal pain, and swelling
- Pathogens are dependent on patient's age. Men < 35: Chlamydia and Gonorrhea; Men > 35: E. Coli
- Testicular torsion should be ruled out in all cases of new-onset testicular pain
- Associated symptoms include pain that is gradual in onset with tenderness posterior to the testis, high riding testicle, absence of cremasteric reflex, and absence of leukocytes on urine analysis.
- Diagnosis involves urinalysis, urine cultures, studies for GC and Chlamydia; ultrasound with Doppler if torsion is suspected
- Treatment depends on age and suspected etiology.
Phimosis
- Foreskin cannot be retracted over the glans penis.
- In adults, phimosis can result from scarring, trauma, infection, or prolonged irritation
- Paraphimosis is the entrapment of the foreskin behind the glans, a medical emergency
- In children, phimosis typically resolves by age 5.
- Treatment for phimosis involves: firm circumferential compression of the glans to restore the foreskin to its normal position. Dorsal slit (local anesthetic) if compression is ineffective. Circumcision may be performed if edema or pain continues.
Testicular Torsion
- Twisting of the spermatic cord resulting in decreased blood flow and ischemia
- Often after vigorous activity or minor trauma
- Primarily affects 10-20-year-old boys
- Symptoms are usually sudden/rapid onset.
- Significant findings include asymmetric high riding testicle ("bell clapper deformity"), negative Prehn's sign (lifting the testicle does not relieve the pain), loss of cremasteric reflex, and potential blue dot sign.
- Diagnosis requires testicular Doppler ultrasound
- Treatment involves emergent surgical repair within 6 hours for optimal outcomes.
Varicocele
- Dilated veins in the spermatic cord, described as "bag of worms"
- Worsens when upright or with Valsalva maneuver.
- Improves/decreases in size with elevation or supine position
- Negative transillumination
- Diagnosis involves scrotal ultrasound.
- Treatment may include surgery if painful or causing infertility.
BPH (Benign Prostatic Hyperplasia)
- Part of normal aging process, affecting >90% of men by age 85
- Symptoms include decreased force of urinary stream, hesitancy/straining/starting and stopping, postvoid dribbling, incomplete emptying, frequency, nocturia, urgency, and recurrent UTIs
- Avoid anticholinergics, sympathomimetics and opioids in patients with BPH
- Diagnosis involves: digital rectal exam (uniformly enlarged, firm, and rubbery prostate). Elevated PSA is a correlate for risk of progression (normal PSA < 4)
- Urinalysis to rule out secondary conditions
- Treatment involves observation for mild symptoms, alpha-blockers (rapid relief, rapid symptom relief, and smooth muscle relaxation). 5-alpha reductase inhibitors (reduce size of prostate) and Phosphodiesterase type 5 inhibitors (PDE5 inhibitor - tadalafil) can be used with or without alpha-1 adrenergic blockers.
- Surgery is indicated if symptoms/complications don't respond to medication, or if complications such as recurrent UTIs, urinary calculi, severe bladder dysfunction, or upper tract dilation arise. Surgical options include TURP (transurethral resection of the prostate) and TUIP (transurethral incision of the prostate).
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Description
This quiz covers essential information about cryptorchidism, focusing on its definition, risk factors, and clinical management. Learn about the importance of timely intervention and the recommended surgical procedures for undescended testes. Ideal for those in the field of men's health or pediatrics.
