Men's health Flashcards
What do men tend to use higher rates of?
Tobacco, alcohol, salt, red & processed meat
What are the LUTS?
Storage functional abnormality - urinary frequency, urgency, nocturia, needing to urinate after passing urine
Voiding - weak stream, incomplete emptying
Post-micturition - dribble, sensation of incomplete emptying
What is the most common cause of voiding?
Benign prostate hyperplasia
What new medications can cause LUTS?
Antidepressants, antihistamines, anticholinergics
What is the name of the scoring system?
Internation Prostate Symptom Score (IPSS)
What is the IPSS?
Classify the severity of LUTS and assess the impact of LUTS on the quality of life
What happens when BPH occurs?
Prostate gland enlarges
How to diagnose BPH
Symptoms (voiding)
Prostate exam
Biopsy - shows abnormalities at cellular level
PSA can also be raised with cancer
Treatment for BPH
- Moderate to severe symptoms (IPSS > 8) offer alpha blocker (tamsulosin/doxasozin)
- Enlarged gland and high risk of progression to cancer offer 5-alpha reductase inhibitor (dutasteride/finasterise)
- Moderate to severe voiding symptoms and prostatic enlargement offer both
What to do with alpha blocker
- Take 1st dose at night due to pos hypo
- Titrate slowly over 4-6 weeks
What to do with 5-alpha redcutase inhibitor
Use a condom if partner is pregnant
What is erectile dysfunction?
Persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance
List causes of ED
- Drug effects
- Psychological
- Physical (vasculogenic, neurogenic, anatomical, congenital, hormonal)
How to diagnose ED
- History (medical, psychological, surgical, social
- Examination (physical + rectal if enlarged prostate
- Investigation (10 year CVD risk)
How to manage ED?
- Switch any med causing ED
- Treat with phosphodiesterase-5 inhibitor (sildenafil, tadalafil, vardenafil)
- Prescribe lower dose & titrate up
