Men's Health

Question 1

Psychometric questionnaire for erectile dysfunction

Answer 1

International Index for Erectile Function

Question 2

Ix for erectile dysfunction

Answer 2

• Measure HbA1c or fasting blood glucose
• lipid profile
• morning testosterone
• repeat testosterone reading and measure FSH, LH and prolactin
• DRE
• BP
• BMI
• External genitalia examination

Question 3

Priapism

Answer 3

Persistent erection - admit to hospital

Question 4

Referral

Answer 4

Urology - young men with difficulty obtaining or maintain erection

Endocrinology - hypogonadism

Cardiology - severe CVD

Mental health services

Question 5

Mx of erectile dysfunction

Answer 5

Sildenafil

Lifestyle advice

Question 6

Causes of erectile dysfunction

Answer 6

Vasculogenic - CVD, DM, smoking etc.

Neurogenic central — degenerative disorders (such as multiple sclerosis, Parkinson’s disease, and stroke,

Neurogenic (peripheral) — diabetes mellitus, chronic renal failure

Anatomical or structural — penile cancer, prostate cancer, congenital curvature of the penis, micropenis, hypospadias, epispadias, phimosis.

Hormonal — hypogonadism, hyperprolactinaemia, Cushing’s disease

Psychogenic

Question 7

Drugs associated with erectile dysfunction

Answer 7

Antihypertensives — beta-blockers, verapamil

Diuretics — spironolactone and thiazides.

Antidepressants — tricyclics, monoamine oxidase inhibitors, SSRI

Antiarrhythmic drugs — digoxin, amiodarone.

Antipsychotics - haloperidol.

Hormones and hormone-modifying drugs — 5-alpha reductase inhibitors - finasteride

Recreational drugs

Question 8

Psychogenic cause of ED

Answer 8

Generalised anxiety

Situation anxiety

Question 9

Prostatitis

Answer 9

(UTI): Dysuria, frequency, urgency.

Prostatitis:
Perineal, penile, or rectal pain.
Acute urinary retention, obstructive voiding symptoms
Low back pain, pain on ejaculation.
Tender, swollen, warm prostate (on gentle rectal examination).

Bacteraemia:
Rigors, arthralgia, or myalgia.
Fever, tachycardia.

Question 10

Ix for prostatitis

Answer 10

Mid stream urine sample to confirm UTI
Blood cultures and FBC
DRE

Question 11

Urgent referral for prostatitis

Answer 11

Immunocompromised or has diabetes mellitus.

Pre-existing urological condition (such as benign prostatic hypertrophy or an indwelling catheter)

Question 12

Mx if prostatitis

Answer 12

Ciprofloxacin - 14 days then review

Paracetamol
Fluids