Flashcards in Genitourinary Deck (378)
What is testicular torsion?
sudden onset of pain in one testis, making walking uncomfortable
At what age are you most likely to acquire testicular torsion?
What symptoms can accompany pain in testicular torsion?
Abdominal pain, nausea and vomiting
What is the appearance of a testis in testicular torsion?
inflamed, hot, tender, swollen in one testis (can be intermittent)
How will the testis lie in testicular torsion, in mild and severe?
Mild - high and transversely
Severe - horizontal
What investigations would you do for testicular torsion?
Doppler US - shows lack of blood flow to testis
Surgical exploration - the sooner the better to save the testis
What is the treatment for testicular torsion?
ask for consent for possible orchiectomy and bilateral fixation
expose and untwist testes and fix to scrotum
DD for testicular torsion?
epididymo-orchitis, idiopathic scrotal oedema, tumour, trauma, acute hydrocycle
What is benign prostatic hyperplasia?
hyperplasia of the epithelial and stromal cells of the prostate gland in the transitional zone
What part of the prostate undergoes hyperplasia in benign prostatic hyperplasia?
The transitional zone
Who most commonly gets benign prostatic hyperplasia?
males over 60
What complications does benign prostatic hyperplasia lead to?
Distorts the urethra and obstructs bladder outflow causing urinary retention, recurrent UTI, impaired renal function and haematuria
What are the symptoms of benign prostatic hyperplasia?
frequency and urgency of micturition, nocturia, hesitancy, intermittent flow, poor urine stream/dribbling, incomplete bladder emptying, enlarged smooth rostate, haematuria, bladder stones, UTI
What causes benign prostatic hyperplasia?
What will a rectal examination show in benign prostatic hyperplasia?
enlarged and smooth prostate with a palpable midline sulcus
What investigations should you do for benign prostatic hyperplasia?
urine dipstick, microscopy and culture, FBC, U and E, creatinine, LFTs, increased PSA, US of urinary tract and transrectl and renal
What are the 4 zones in the prostate?
fibro-muscular, transitional, central and peripheral
Where is the most common place for prostate cancer to occur?
In the peripheral zone
What is the management of benign prostatic hyperplasia?
watchful waiting if mild
complete international prostate symptom score
complete voiding diary
selective a1 adrenoreceptor antagonists e.g.tamsulosin
5-a-reductase inhibitor e.g. finasteride
urethral catheterisation if retention
prostatectomy or permanent catheter
avoid caffeine and alcohol
relax when voiding and train bladder
incision of prostate
How do selective a1 adrenoreceptor antagonists e.g.tamsulosin help treat benign prostatic hyperplasia?
They relax smooth muscles in bladder neck and prostate to increase flow rate and reduce symptoms
How to 5-a-reductase inhibitor e.g. finasteride help treat benign prostatic hyperplasia?
They block the conversion of testosterone to dihydrotesterone to reduce dihydrotestosterone
What is an epididymal cyst?
A non malignant scrotal disease just above the testis that contains spermatocele fluid
When are you most likely to get an epididymal cyst?
What is the treatment of an epididymal cyst?
No treatment unless symptomatic, then remove
What is hydrocele?
Fluid within the tunica vaginalis
What are the causes of hydrocele?
primary - patent processus vaginalis
secondary - tumour, trauma, infection
What is the treatment of hydrocele?
Primary can resolve spontaneously, aspirate or surgery of placating the tunica vaginalis or inverting the sac
What is a varicocele?
Dilated veins of the pampiniform plexus, normally on the left, appear as dilated scrotal blood vessels, will a dull ache
What are potential complications of a varicocele?
Can be associated with subfertility and a dull ache