Andrology

Question 1

how common is varicocele?

Answer 1

15% in general population

30% in infertile men

Question 2

what is the classification for varicocele?

Answer 2

Hudson
grade 3 visible
2 palpable on standing
1 palpable with valsalva
0 subclinical

Question 3

why does OAT occur in varicocele?

Answer 3

higher intrascrotal temp
ROS
reflux

Question 4

evidence for varicocelectomy for subfertility

Answer 4

pregnancy rate
Ficarra: 20 -> 36%
Marmar: odds 2.6

Question 5

what are the techniques for varicocelectomy?

Answer 5

high retro Palomo
inguinal Ivanissevich
subinguinal Marmar
Lap

Question 6

Hydrocele and failure rate of microscopic subinguinal varicocelectomy

Answer 6

hydrocele 0%

failure 1.4%

Question 7

types of priapism

Answer 7

ischemic
non-ischemic
stuttering

Question 8

name the corporoglandular shunts for priapism

Answer 8

percutaneous: Winter, Ebbehoj, T-shunt
open: Al-Ghorab, Burnett

Question 9

name the proximal shunts for priapism

Answer 9

Quackels/Sacher: corporospongiosal
Grayhack: corporosaphenous
Barry: dorsal vein shunt (corporo-)

Question 10

what blade is used for T-shunt?

what dilator size is used for tunnelling?

Answer 10

#10
Fr 20 - 24

Question 11

what are the stages of spermatogenesis?

Answer 11

neonatal gonocyte, adult dark spermatogonia, pale
meiosis 1: primary spermatocyte
meiosis 2: secondary spermatocyte
spermatid
spermatozoa

Question 12

what is retrograde ejaculation

Answer 12

failure bladder neck contraction

propulsion of sperm back

Question 13

what is Liverpool solution?

Answer 13

NaCl NaHCO3

alkalinize post-orgasmic urine

Question 14

what are the methods of sperm retrieval for anejaculation?

Answer 14

Above T10/intact bulbocavernosus reflex: penile stimulation

Below T10: Seager electro-ejaculator to stimulate perirectal and periprostatic sympathetic nerves

Question 15

Most common mode of inheritance for Kallmann syndrome

Answer 15

X-linked recessive

Question 16

How common is =
Obstructive azoospermia
Obstruction at epididymis, ejaculatory duct?

Answer 16

20%
epididymis 50%
ejaculatory duct < 3%

Question 17

CTFR gene

Ch =?

Answer 17

Ch 7

Question 18

WHO 2010 lower limit wrt sperm parameters:
volume
total
sperm conc
total motility
vitality
morphology

Answer 18

1.5ml
39
15
40
58
4

Question 19

what is Cap-score?

Answer 19

Ganglioside localization pattern (apical = good)

calcium influx and capacitation

Question 20

what is Johnsen score?

Answer 20

1 - 10
1 = fibrosis
10 = complete spermatogensis

Question 21

Risks of chromosomal abnormalities and congenital malformation associated with ART?

Answer 21

3X

OR 1.29

Question 22

what ART technique will you choose for:
Irreversible OA
Reversible OA
NOA

Answer 22

PESA
MESA / ART
mTESe

Question 23

what is mTESE

Answer 23

microdissection
seminiferous tubules
identify enlarged tubules

Question 24

Failure rate of various vasal occlusion techniques = ?

Answer 24

Mucosal cautery: 0.28%
Suture ligation: 0.51%
Marie Stopes: 0.64%

Question 25

Post-vasectomy semen analysis Mx

Answer 25

One azoopsermic | after 12wk , 20 eja

Question 26

Special clearance for post-vasectomy

Answer 26

One SA < 100,000/ml, immotile 12 wk

Question 27

Factors related to successful vasectomy reversal

Answer 27

``` interval expertise length vasal fluid sperma granuloma young female partner ```

Question 28

Pregnancy rate post-vasectomy reversal (VVSG)

Answer 28

< 3: 76% 3 - 8: 53% 9 - 14: 44% > 15: 30%

Question 29

Neurology wrt erection: somatosensory somatomotor parasympathetic

Answer 29

pudendal S2 - 4 Onuf S2 - 4 cavernosal nerve

Question 30

serum testosterone components

Answer 30

free + alb-bound + SHBG-bound

Question 31

T 1/2 Viagra Cialis

Answer 31

4h | 18h

Question 32

how common is hypogonadism

Answer 32

18% in > 70y

Question 33

Absolute and relative contraindications of T replacement

Answer 33

2 + 5

Question 34

regarding ejaculation and their spinal levels: secretory centre mechanical centre

Answer 34

T10 - L2 | S2 - 4

Question 35

what is Dapoxetine? | efficacy

Answer 35

Priligy SSRI 3 fold increase in IELT

Question 36

Peyronie's disease | ___ over-expression

Answer 36

TGF-B1

Question 37

Peyronie: | most common location

Answer 37

dorsal 78%

Question 38

Peyronie: natural history

Answer 38

48% worse 40% stable 12% better

Question 39

Peyronie: postulated mechanisms: Colchicine vit E POTABA

Answer 39

anti-inflam/stimulate collagenase/down-reg TGF-a antioxidant potassium para-aminobenzoate, enhanced O2 uptake

Question 40

Peyronie: efficacy of LiESWT

Answer 40

pain relief only

Question 41

what is Nesbit procedure?

Answer 41

plication | excision of elliptical portion of TA