Diseases And Conditions Flashcards
(28 cards)
Disease Focus
Diseases of the male reproductive system include reproductive disorders, congenital abnormalities, diseases and infections, and various types of cancers. Signs and symptoms commonly include pain, especially during urination; erectile dysfunction; and loss of libido. Performance of a complete evaluation of the genitalia, reproductive history, and past and present genitourinary infections and disorders is necessary to identify disorders associated with male reproductive structures. For diagnosis, treatment, and management of male reproductive disorders, the medical services of a specialist may be warranted. Urology is the branch of medicine concerned with the male reproductive system and urinary disorders in males and females. The physician who specializes in diagnosis and treatment of genitourinary disorders is known as a urologist.
Sexually transmitted infections (STIs), also called sexually transmitted diseases (STDs), include any contagious disease acquired during sexual activity with an infected partner. In the United States, the widespread occurrence of STIs is regarded as epidemic. The Centers for Disease Control estimates that there are nearly 20 million new STIs annually, and half of these are among young adults between 15 and 24 years old. Because genital warts, genital herpes, and trichomonas infections are not routinely reported, the current statistics of STIs captures only a fraction of the actual number of these cases. Many STIs can lead to severe reproductive problems, including sterility and infertility in males and females and ectopic pregnancy, preterm delivery, and infection transmitted to the newborn during delivery in females. In addition, many STIs increase the risk of acquiring HIV infection.
Gonorrhea
Gonorrhea is caused by the bacterium Neisseria gonorrheae. It involves the mucosal surface of the genitourinary tract and can also involve the rectum and pharynx. This disease spreads through sexual intercourse and through orogenital and anogenital contact. The most common symptoms of gonorrhea include pain on urination (dysuria) and a white discharge (leukorrhea). Left untreated, the disease may infect the bladder (cystitis) and inflame joints (arthritis). In males, gonorrhea can cause epididymitis that leads to infertility or scarring inside the urethra, making urination difficult. Many women are asymptomatic; however, when symptoms are present, they include a vaginal discharge or pelvic pain. Scars may develop in the reproductive tubes and cause infertility. The organism can infect the eyes of the newborn during vaginal delivery, leading to blindness. As a precaution, physicians instill silver nitrate in the eyes of all newborns immediately after delivery as a preventive measure to ensure that this infection does not occur. Both sex partners require treatment for gonorrhea because the infection can recur. The usual treatment is antibiotics.
Chlamydia
Chlamydia, caused by infection with the bacterium Chlamydia trachomatis, is the most prevalent and one of the most damaging STIs in the United States. It is called the “silent disease” because symptoms are commonly absent or mild, and the disease remains untreated until there is irreversible damage to the reproductive structures. If symptoms are present, males produce a whitish discharge from the penis. Inflammation of epididymis (epididymitis) can cause pain and swelling in the scrotum. In women, there is a mucopurulent discharge and inflammation of the cervix uteri (cervicitis). During the birth process, chlamydia may spread to the newborn baby and cause conjunctivitis or pneumonia. Antibiotics are effective in treating chlamydia infections. Screening for other STIs is important because chlamydia places the individual at higher risk of having other STIs, including gonorrhea and HIV.
Syphilis
Although less common than gonorrhea, syphilis is the more serious of the two diseases. It is caused by the bacterium Treponema pallidum. If left untreated, syphilis may become a chronic, infectious, multisystemic disease.
Syphilis manifests in three distinct stages. In primary syphilis, a painless sore, called a chancre appears 3 to 90 days after exposure. In secondary syphilis, a body rash that that commonly occurs on the palms of the hands and soles of the feet appears 4 to 10 weeks after exposure. A latency period of several years usually follows when sign and symptoms are absent or very mild; however, the individual is still infectious. Tertiary syphilis develops 3 to 15 years after exposure when the disease spreads throughout the body, especially in the nervous and cardiovascular systems. Early treatment is very effective, sometimes with just a single injection. Without treatment, the disease becomes life-threatening, causing blindness, stroke, mental disorders, and eventually, death.
Genital Herpes
Genital herpes causes red, blisterlike, painful lesions in the genital area that closely resemble fever blisters or cold sores that appear on the lips and around the mouth. Although genital herpes and oral herpes are caused by the herpes simplex virus (HSV), genital herpes is associated with type 2 (HSV-2), and oral herpes is associated with type 1 (HSV-1). Regardless, both forms can cause oral and genital infections through oral-genital sexual activity. Fluid in the blisters in genital herpes is highly infectious and contains the active virus. However, this disease is communicable even when the blisters are not present, through a phenomenon called viral shedding. In men, lesions appear on the glans, foreskin, or penile shaft. In females, lesions appear in the vaginal area, buttocks, and thighs. Individuals with a herpes infection may have only one episode or may have repeated attacks that usually lessen in severity over the years. The disease may spread to a baby during the birth process and, although rare, may lead to death of the infant. Antiviral medication can relieve pain and discomfort during an outbreak by healing the sores more quickly. However, there is no cure available for this disease.
Genital Warts
Genital warts (condylomata, condylomas) are caused by one or more of the many different human papillomavirus (HPV) strains. The warts may be very small and barely visible or may be large and appear in clusters. HPV can spread from one person to another during skin-to-skin contact and does not require sexual activity. The warts can also spread from one part of the body to another. In males, the lesions commonly appear on the penis or around the rectum. In females, the lesions commonly appear on the vulva, in the vagina, or on the cervix.
Some high-risk strains of HPV are associated with anal and penile cancer in males and vaginal and cervical cancer in females. Females diagnosed with high-risk strains of HPV require regular Pap smears. HPV vaccines are available and protect against the high-risk strains. To be effective, young adults require vaccination before they begin engaging in sexual activity. Many warts disappear without treatment, but there is no way to determine which ones will resolve. When treatment is required, the usual method is surgical excision or freezing the wart.
Trichomoniasis, caused by the protozoan Trichomonas vaginalis, affects males and females but symptoms are more common in females. When symptoms are present in males, they include irritation inside the penis, mild discharge, or slight burning during urination (dysuria) or ejaculation. In women, trichomonas causes vaginitis, urethritis, and cystitis with discomfort during urination or intercourse. Often there is a frothy, yellow-green vaginal discharge with a strong odor and irritation or itching of the vulva. Both sexual partners require treatment because reinfection is possible.
Oncology
Prostate cancer is one of the most common forms of cancer among men, second only to skin cancer. With early diagnosis and treatment, the prognosis for long-term survival is excellent.
In the United States, men younger than age 50 rarely develop prostate cancer. However, the incidence dramatically increases with age. Early presymptomatic tests include a blood test for prostate-specific antigen (PSA) and periodic digital rectal examination (DRE). In early stages of prostate cancer, symptoms include dysuria, frequency, loss of bladder control, and hematuria. As prostate cancer progresses, symptoms include blood in the semen, erectile dysfunction, and numbness or pain in the pelvis.
Once diagnosed, oncologists stage and grade prostate cancer to determine appropriate forms of therapy. Very early stages of prostate cancer may not require medical intervention, and many men may never need any further treatment. Nevertheless, active surveillance with blood tests, digital rectal examinations, and possibly biopsies with follow-up is required.
Surgery and radiation therapy are common treatments for prostate cancer. For malignancy confined only to the prostate, surgery that removes the entire prostate, seminal vesicles, and surrounding lymph nodes (radical prostatectomy) provides the best treatment option. Because testosterone fuels the growth of prostate cancer, hormone therapy, called androgen-deprivation therapy (ADT), is important in the management of the disease. Removal of both testes (bilateral orchiectomy, castration) blocks testosterone but is permanent and irreversible, and many men opt for drug therapy. Drug therapy that includes antiandrogenic agents and hormones that deplete the body of testicular hormones (combined hormonal therapy) is part of this form of treatment.
Enlargement of the prostate, usually as part of the aging process that constricts the urethra, causing urinary symptoms including frequency, hesitancy, nocturia, and urinary retention (See Fig. 13-2.)
Urine that remains in the bladder commonly becomes a breeding ground for bacteria, causing cystitis and, ultimately, nephritis.
benign prostatic hyperplasia (BHP)
bē-NĪN prŏs-TĂT-ĭk hī-pĕr-PLĀ-zē-ă
prostat: prostate
-ic: pertaining to
hyper-: excessive, above normal
-plasia: formation, growth
Inflammation of the skin covering the glans penis, caused by bacteria, fungi, or a virus
Uncircumcised men with poor personal hygiene are prone to this disorder.
balanitis
băl-ă-NĪ-tĭs
balan: glans penis
-itis: inflammation
Repeated inability to initiate or maintain an erection sufficient for sexual intercourse
Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED.
erectile dysfunction (ED)
ĕ-RĔK-tīl
Decrease or lack of hormones normally produced by the gonads
Hypogonadism involves a lack of testosterone, which plays a key role in masculinization and development during puberty.
hypogonadism
hī-pō-GŌ-năd-ĭzm
hypo-: under, below, deficient
gonad: gonads, sex glands
-ism: condition
Congenital abnormality in which the opening of the male urethra is on the undersurface of the penis, instead of at its tip
hypospadias
hī-pō-SPĀ-dē-ăs
hypo-: under, below, deficient
-spadias: slit, fissure
Stenosis or narrowing of foreskin so that it cannot be retracted over the glans penis
phimosis
fī-MŌ-sĭs
phim: muzzle
-osis: abnormal condition; increase (used primarily with blood cells)
Prolonged, commonly painful erection of the penis, which occurs without sexual stimulation
Priapism is associated with sickle cell disease, leukemia, spinal cord injury, and as an adverse effect of drugs used to treat erectile dysfunction. Prompt treatment is necessary to prevent permanent tissue damage that could result in the erectile dysfunction or disfigurement of the penis.
priapism
PRĪ-ă-pĭzm
Acute or chronic inflammation of the prostate
Prostatitis is commonly caused by a urinary tract infection or a sexually transmitted infection
prostatitis
prŏs-tă-TĪ-tĭs
prostat: prostate
-itis: inflammation
Inability to produce offspring
In the male, sterility is the inability to fertilize the ovum.
sterility
stĕr-ĬL-ĭ-tē
Any of the various disorders that affect the testes (See Fig. 13-3.)
- Absence of one or both testicles; also called anorchia or anorchidism
Treatment includes androgen (male hormone) supplementation, testicular prosthetic implantation, and psychological support.
testicular abnormalities
anorchism
ăn-OR-kĭzm
an-: without, not
orch: testis (plural, testes)
-ism: condition
Testicular abnormality
Inflammation of the epididymis (See Fig. 13-3A.)
Epididymitis is most common in males between ages 14 and 35 and is usually associated with STIs, especially gonorrhea and chlamydia.
epididymitis
ĕp-ĭ-dĭd-ĭ-MĪ-tĭs
epididym: epididymis
-itis: inflammatio
Testicular abnormality, Swelling of the sac surrounding the testes that is typically harmless (See Fig. 13-3B.)
Hydrocele in a neonate usually resolves without treatment within a year. In men and young males, it is commonly caused by inflammation or injury to the scrotum.
hydrocele
HĪ-drō-sēl
hydr/o: water
-cele: hernia, swelling
Testicular abnormality Painful swelling of one or both testes commonly associated with mumps that develop after puberty (See Fig. 13-3C.)
Other causes of orchitis include infection of the epididymis or STIs.
orchitis
or-KĪ-tĭs
orch: testis (plural, testes)
-itis: inflammation
Testicular abnormality Abnormal, fluid-filled sac that develops in the epididymis and may or may not contain sperm; also called spermatic cyst (See Fig. 13-3D.)
spermatocele
spĕr-MĂT-ō-sēl
spermat/o: spermatozoa, sperm cells
-cele: hernia, swelling
