lecture 24 - mens health

Question 1

what is balanitis - condition affecting penis?

Answer 1

pain and inflammation (swelling and irritation) of the glans. completely red or patchy

Question 2

what is phimosis - condition affecting penis ?

Answer 2

a condition where the foreskin remains unusually tight and cannot be drawn back, leading to pain, urianation difficulties and caressed risk infection

Question 3

what is testicular torsion - condition affecting testicles ?

Answer 3

a medical emergency due to the rotation and twisting of the testicle, causing pain and inflammation and eventually cutting off the blood supply.

Question 4

What is epididymitis?

Answer 4

pain and inflammation f the epididymis which is back of the testicles. most feted caused by a bacterial infection such as chlamydia or gonorrhoea and treated with antibiotics and measures to relive discomfort. testicle may also become inflamed.

Question 5

what are benign causes of testicular lumps or swelling ?

Answer 5

varicoceles - soft lumps that develop gradually above the testicle on the left side of the scrotum

hydroceles - swelling in the scrotum caused by a build-up of fluid

epidydimal cysts - a small, smooth fluid-filled swelling that slowly develops in the epididymis

inguinal hernias - when fatty tissue or part of the bowel pokes through the groin at the top of the inner thigh

testicualr cancer

Question 6

What is Peyronie’s disease?

Answer 6

scar tissue or a hard lump forms inside the penis. Cause is not known although trauma may be involved.

can improve wihtout treatmnet in 6-15 months. hardened tissue can make penis less flexible, more painful durign erection or make intercourse difficult

Question 7

What is priapism

Answer 7

persistent erection that lasts at least 4 hours
usually painful, and may not be related to sexual stimulation or activity. Left untreated, it can cause lasting damage to the penis

Question 8

What is haematospermia?

Answer 8

Visible blood in the ejaculate, commonly due to infection or recent urological procedures.

Question 9

what is a normal erection ?

Answer 9

to achieve adequate peniel tumescence for successful penetrative intercourse, blood flow within the corpus cavernous needs to increase

Question 10

how is an erectile dysfunction defined?

Answer 10

Persistent inability to attain and maintain an erection for satisfactory sexual performance.

Question 11

what are common causes of erectile dysfunction ?

Answer 11

vascular, neuronal, hormonal, and metabolic factors, mediated by endothelial and smooth muscle dysfunction

Question 12

what is the role of dopamine in sexual function ?

Answer 12

dopamine enhances sexual motivation and performance.

dopamine in other parts of the brain controls genital reflexes, sexual configurations, and specifically libido. the dopamine hypothesis of psychosis is a model that attributes symptoms of schizophrenia to a disturbed and overactive active dopamine signalling

Question 13

what is prolactin ?

Answer 13

prolactin secretion is suppressed by dopamine. high prolactin = low sex drive as prolactin decreases sex hormones like testosterone

high dopamine = low prolactin = high sex drive

Question 14

explain serotonin and sexual behaviour

Answer 14

prolonging the effects of serotonin is thought to be a major action of several classes of pharmacological antidepressants

serotonin generally inhibits sexual activity. sexual behaviour is impaired by many serotonin agonists.

Question 15

what are diseases that can cause sexual dysfunction ?

Answer 15

HBP. Decreased blood flow interferes with (men) erections, ejaculations and sexual desire and (women) sexual desire, orgasm and vaginal dryness

high cholesterol

diabetes

mental health

hormonal imbalance

chronic dises renal or liver

Question 16

what are ways in which medicines can impact sexual dysfunction ?

Answer 16

desire disorders

arousal disorders

pain disorders

orgasm disorders

Question 17

what are main drug classes causing sexual dysfunction ?

Answer 17

Anti-psychotics
Anti-depressants
Anti-hypertensives
Anti-epileptics
Recreational/substances of abuse
Others

Question 18

what are ‘other’ drugs causing sexual dysfunction

Answer 18

Anti-parkinsonian drugs: L-dopa may cause hypersexuality as a side effect in some cases.

Benzodiazepines act as hypnotics and cause drowsiness, thus reducing desire. In certain doses they can be disinhibiting and may increase libido.

Antacids – cimetidine and ranitidine affect histamine - may play a role in human penile erection. The erection-promoting action of histamine is probably due to H2 receptor activation, although another histamine receptor, possibly H3, also seems to be involved.

Question 19

How do PDE5 inhibitors (e.g., Sildenafil) work in treating ED?

Answer 19

They inhibit PDE5 in the cavernous smooth muscle and prevent the breakdown of cGMP to GMP. nitric oxide mediated smooth muscle relaxation is therefore facilitated in both corpus cavernous and cavernosal arteries

Question 20

what are storage, voiding and post-micturation symptoms of lower urinary tract symptoms ?

Answer 20

storage symptoms include urgency, daytime urinary frequency, nocturne, urinary incontinence, and feeling the need to urinate again just after passing urine.

Voiding symptoms include hesitancy, weak or intermittent urinary stream sometimes causing splitting or spraying, straining, intermittency, incomplete emptying, and terminal dribbling

Post-micturition symptoms include post-micturition dribble and the sensation of incomplete emptying

Question 21

what are common conditions related to LUTS in men

Answer 21

Benign prostatic hyperplasia (BPH) — biopsy of the prostate shows histologic signs of hyperplastic changes

Benign prostatic enlargement — enlargement of the prostate gland by BPH.

Bladder outlet obstruction — obstruction during voiding. It is diagnosed when urodynamic voiding studies show increased detrusor pressure and reduced urine flow rate

Question 22

what are lower Urinary Tract Symptoms ?

Answer 22

Overactive bladder — a syndrome of storage symptoms, including urinary urgency, with or without urgency incontinence; frequency; and nocturia. Usually caused by detrusor overactivity

Detrusor overactivity — characterized by involuntary detrusor contractions during the bladder filling phase which may be spontaneous or provoked.

Question 23

what are the potential causes of LUTS

Answer 23

causes of overactive bladder symptoms:
BPH or BPE

DIABETES or stroke

Lower utilities, prostates and sexually transmitted disease

-blader stones

• cancer of the bladder and prostate

Question 24

what are the recommended treatments for overactive bladder symptoms or LUTS storage

Answer 24

prudent fluid intake

lifestyle measures

temporary urine contaminant products

Referral for supervised bladder training
first lien medication if symptoms persist
- oxybutynin, tolterodine, daliferacin

Question 25

what are the causes of urinary voiding symptoms ?

Answer 25

benign prostatic hyperplasia and benign prostate enlargement are the most common causes drugs with antimuscarinic actions include TCAs, sedating antihistamines, Antimuscarinic drugs for urinary incontinence, Disopyramide Diabetic autonomic neuropathy & neurogenic bladder, Urethral stricture & phimosis (foreskin constriction), Cancer of the prostate, bladder, or rectum

Question 26

what are treatment option for urianry voiding ?

Answer 26

moderate-to-severe voiding symptoms offer an alpha blocker (alfuzosin, doxazosin, tamsulosin or terazosin) if enlarged prostate and is considered to be at high risk of progression offer a 5-alpha reductase inhibitor (dutasteride or finasteride). If bothersome moderate-to-severe voiding symptoms and prostatic enlargement, consider offering a combination of an alpha-blocker and a 5-alpha reductase inhibitor

Question 27

what are lower urinary tract storage symptoms ?

Answer 27

lower urinary tract symptoms include oxybutynin or mireabegrn if antimuscarinic effects are intolerable