Men's Health - Penile
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What is the main difference between phimosis and paraphimosis?

  • Phimosis occurs in newborns, while paraphimosis is most commonly found in adolescents.
  • Phimosis requires circumcision for treatment, while paraphimosis can be managed with topical betamethasone.
  • Phimosis involves inability to retract the foreskin, while paraphimosis is when the foreskin is left retracted behind the glans. (correct)
  • Phimosis leads to arterial compromise and gangrene, while paraphimosis results in painful engorgement and edema of the glans.

    • What is a common risk factor for both phimosis and paraphimosis?

  • Circumcision
  • Penile pain
  • Infection (correct)
  • Wet prep test

    • How can paraphimosis be effectively reduced in most cases?

  • With compression of the glands for several minutes (correct)
  • By performing a wet prep test
  • Through circumcision
  • By applying betamethasone topically

    • Why is paraphimosis considered a urological emergency?

    <p>It can result in arterial compromise and gangrene. (D)</p> Signup and view all the answers

    At what age do fewer than 10% of foreskins remain nonretractile?

    <p>3 years (B)</p> Signup and view all the answers

    What should be done if a patient with phimosis presents with pain or fever?

    <p>Rule out yeast infection with a wet prep test (C)</p> Signup and view all the answers

    What is the curative management for phimosis?

    <p>Circumcision (B)</p> Signup and view all the answers

    Why does phimosis naturally occur in uncircumcised newborns?

    <p>As a result of the foreskin potential (D)</p> Signup and view all the answers

    What has been shown as an effective nonsurgical management option for phimosis?

    <p>Topical betamethasone (D)</p> Signup and view all the answers

    What is a common risk factor for Peyronies disease?

    <p>Family history of the condition (A)</p> Signup and view all the answers

    Which of the following diseases is NOT linked to Peyronies disease?

    <p>Diabetes (B)</p> Signup and view all the answers

    What is the typical presentation of Peyronies disease?

    <p>Penile curvature upon erection that may or may not be painful (A)</p> Signup and view all the answers

    Why is ultrasound often needed in diagnosing Peyronies disease?

    <p>To confirm the presence of Peyronies disease (A)</p> Signup and view all the answers

    What is the recommended referral for patients with Peyronies disease?

    <p>Outpatient urological referral (B)</p> Signup and view all the answers

    What is the most common causative agent for Prostatitis?

    <p>E. coli (D)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for Prostatitis?

    <p>Cystic fibrosis (A)</p> Signup and view all the answers

    Which symptom is commonly complained about by patients with Prostatitis?

    <p>Genital discomfort (A)</p> Signup and view all the answers

    What is the initial treatment recommended for infectious prostatitis?

    <p>Fluoroquinolone antimicrobial therapy for 2 weeks (A)</p> Signup and view all the answers

    What is contraindicated in the case of acute bacterial prostatitis?

    <p>Prostate massage and expression of prostatic secretions (B)</p> Signup and view all the answers

    A patient with ________ will most likely complain of irritative or obstructive symptoms such as low back pain, perineal, suprapubic, or genital discomfort. These patients might have lower UTI symptoms, fevers or chills

    <p>prostatitis (B)</p> Signup and view all the answers

    Presence of __________ in expressed prostatic secretions but with a negative culture is indicated of non-infectious prostatitis

    <p>white blood cells (D)</p> Signup and view all the answers

    Prostatitis is most common in younger or middle-aged men

    <p>True (A)</p> Signup and view all the answers

    Benign prostatic hyperplasia is a common condition that only affects young men.

    <p>False (B)</p> Signup and view all the answers

    Blood work to check PSA levels should be drawn after examination of the prostate.

    <p>False (B)</p> Signup and view all the answers

    What presenting symptoms are commonly associated with Benign Prostatic Hypertrophy (BPH)?

    <p>Hesitancy and straining during urination (A)</p> Signup and view all the answers

    Which tool is important in evaluating patients with Benign Prostatic Hypertrophy?

    <p>American Urological Association (AUA) symptom index (B)</p> Signup and view all the answers

    What diagnostic finding is essential for confirming a diagnosis of BPH?

    <p>Enlarged prostate size on rectal exam (A)</p> Signup and view all the answers

    Which factor is NOT a known risk factor for Benign Prostatic Hypertrophy?

    <p>Recent chest surgery (C)</p> Signup and view all the answers

    Why is a urinalysis important in the diagnosis of Benign Prostatic Hypertrophy?

    <p>To exclude infection or hematuria (C)</p> Signup and view all the answers

    What is the most common site of metastases in prostate cancer?

    <p>Axial skeleton (C)</p> Signup and view all the answers

    According to the USPSTF, which age group should have an individual conversation with their providers regarding periodic PSA screening (grade C)?

    <p>55-69 years old (C)</p> Signup and view all the answers

    What determines the grading of prostate cancer?

    <p>Gleason Score (D)</p> Signup and view all the answers

    What is a risk factor for prostate cancer?

    <p>High dietary fat intake (C)</p> Signup and view all the answers

    What is the standard method for detecting prostate cancer?

    <p>Transrectal ultrasound-guided biopsy (D)</p> Signup and view all the answers

    The USPSTF recommends against PSA screening in men 70 years and older

    <p>True (A)</p> Signup and view all the answers

    Androgen is commonly used in prostate cancer, but this can cause “feminization” and loss of sex drive

    <p>True (A)</p> Signup and view all the answers

    A high PSA threshold excludes the diagnosis of prostate cancer

    <p>False (B)</p> Signup and view all the answers

    Prostate cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related death in American men

    <p>True (A)</p> Signup and view all the answers

    What is the most common type of penile cancer?

    <p>Squamous cell carcinoma (B)</p> Signup and view all the answers

    What is a major risk factor for penile cancer?

    <p>Smoking (D)</p> Signup and view all the answers

    What is the recommended approach for males with a suspicious penile lesion?

    <p>Immediate biopsy (A)</p> Signup and view all the answers

    What is the single most important prognostic factor for survival in penile cancer patients?

    <p>Presence of nodal metastases (B)</p> Signup and view all the answers

    Which treatment approach may be considered for men with a small distal, noninvasive primary tumor?

    <p>Radiation therapy (D)</p> Signup and view all the answers

    In the context of penile cancer, what is the recommended approach for patients with high risk of recurrence and extensive primary tumor involvement?

    <p>Penile amputation (D)</p> Signup and view all the answers

    Study Notes

    Phimosis

    • Phimosis is the inability to retract the foreskin proximally and posterior to the glans penis.
    • All patients with foreskin have a potential for phimosis.
    • Risk factors for phimosis include infection, poor hygiene, and previous preputial injuries with scarring.
    • Phimosis is diagnosed clinically, and treatment options include circumcision and betamethasone topical for 1-2 months.

    Paraphimosis

    • Paraphimosis occurs when the foreskin is left retracted behind the glans, resulting in painful engorgement and edema of the glans.
    • Risk factors for paraphimosis include having a foreskin.
    • Paraphimosis is a true urological emergency and can be reduced by compression of the glands for several minutes.

    Peyronie's Disease

    • Peyronie's disease is more common in men in their 50s and 60s.
    • Risk factors for Peyronie's disease include heredity, connective tissue disorders, and family history.
    • Peyronie's disease presents as curvature of the erect penis, which may or may not be painful.
    • Diagnosis is clinical, and management requires outpatient urological referral.

    Prostatitis

    • Prostatitis is most common in younger or middle-aged men.
    • Risk factors for prostatitis include anatomic or neurophysiological lower urinary tract obstruction, acute epididymitis, urethritis, and anal receptive intercourse.
    • Prostatitis presents with irritative or obstructive symptoms, such as low back pain, perineal, suprapubic, or genital discomfort.
    • Diagnosis includes perineal tenderness, rectal sphincter spasm, and prostatic tenderness or bogginess.
    • Initial treatment for infectious prostatitis is fluoroquinolone antimicrobial therapy for 2 weeks.

    Benign Prostatic Hyperplasia (BPH)

    • BPH is a common condition as men get older.
    • Risk factors for BPH include aging, family history of BPH, diabetes, heart disease, and obesity.
    • BPH presents with obstructive symptoms, such as hesitancy, decreased force and caliber of the stream, and sensation of incomplete bladder emptying.
    • Diagnosis includes clinical finding of obstructive or irritative voiding symptoms and enlarged prostate size on rectal exam.

    Prostate Cancer

    • Prostate cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related death in American men.
    • Risk factors for prostate cancer include black race, family history of prostatic cancer, and history of high dietary fat intake.
    • Most prostate cancers are asymptomatic and are diagnosed because of elevations in serum PSA.
    • Transrectal ultrasound-guided biopsy is the standard method for detection of prostate cancer.
    • Gleason Score determines the grading of prostate cancer.

    Penile Cancer

    • Carcinoma of the penis typically presents as a painless lump or ulcer on the penis.
    • Most cases of penile cancer are epithelial squamous cell carcinoma (SCC).
    • Risk factors for penile cancer include smoking and human papillomavirus (HPV) DNA.
    • Penile cancer is diagnosed with biopsy, and treatment depends on the extent of nodal metastases.

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