Penile Disorders

Question 1

What histological type of cancer is penile cancer?

Answer 1

Squamous cell carcinoma

Question 2

What is the typical demographic of individual to be affected by penile cancer?

Answer 2

Older, uncircumcised men (particularly in developing countries)

Question 3

The differentiated type of penile cancer is usually a result of what?

Answer 3

Chronic inflammation

Question 4

The undifferentiated type of penile cancer is usually a result of what?

Answer 4

HPV type 16/18 infection

Question 5

How does squamous cell carcinoma in situ present on the penis?

Answer 5

Red, velvety plaques

Question 6

What is squamous cell carcinoma in situ known as if it is located on the glans, foreskin or shaft of the penis?

Answer 6

Erythroplasia of Queyrat

Question 7

What is squamous cell carcinoma in situ known as if it is located on any part of the male genitalia apart from the glans, foreskin or shaft of the penis?

Answer 7

Bowen’s disease

Question 8

Other than squamous cell carcinoma in situ, what is another pre-cancerous lesion of the penis?

Answer 8

BXO (lichen sclerosus)

Question 9

How can pre-cancerous lesions of the penis usually be treated?

Answer 9

Circumcision

Question 10

Penile cancer tends to spread to which lymph nodes?

Answer 10

Inguinal

Question 11

How do penile cancers tend to present?

Answer 11

Ulcerating lesions on the glans or foreskin, which may be associated with pain and a foul smelling discharge

Question 12

How are early cases of penile cancer treated?

Answer 12

Radiotherapy and irridium wires

Question 13

How are late cases of penile cancer treated?

Answer 13

Amputation and lymph node dissection

Question 14

What are the two most common causative organisms of urethritis?

Answer 14

Neisseriae gonorrhoeae and chlamydia trachomatis

Question 15

How does urethritis typically present in men?

Answer 15

Purulent urethral discharge

Question 16

What is balanitis?

Answer 16

Inflammation of the foreskin and glans penis

Question 17

What cause of balanitis typically occurs after intercourse, and is associated with itching and a white non-urethral discharge? How should this be treated?

Answer 17

Candida - topical clotrimazole

Question 18

What cause of balanitis is usually painful and can be itchy with a yellow non-urethral discharge? How should this be treated?

Answer 18

Bacterial - oral flucloxacillin

Question 19

What cause of balanitis is associated with the presence of Wickham’s striae and violaceous papules? How should this be treated?

Answer 19

Lichen planus - high potency topical steroids e.g. clobetasol

Question 20

How should balanitis caused by dermatitis be treated?

Answer 20

Low potency topical steroids e.g. hydrocortisone

Question 21

What cause of balanitis is associated with the formation of white plaques and may cause significant scarring? How should this be treated?

Answer 21

Lichen sclerosus (BXO) - circumcision

Question 22

What is meant by the term phimosis?

Answer 22

The foreskin cannot be retracted

Question 23

In adults, phimosis is associated with what condition?

Answer 23

BXO

Question 24

What is meant by the term paraphimosis?

Answer 24

The foreskin cannot be pulled forwards over the tip of the penis

Question 25

What is the risk of paraphimosis- why is it a urological emergency?

Answer 25

It prevents venous return and risk ischaemia of the glans penis

Question 26

What are some management options to try to relieve paraphimosis?

Answer 26

Manual compression of the glans penis, 50% glucose soaked swab, ice packs, lidocaine gel

Question 27

What surgical options are available to treat paraphimosis if conservative management fails?

Answer 27

Aspiration, dorsal slit, circumcision

Question 28

What is meant by the term priapism?

Answer 28

A persistent erection lasting > 4 hours

Question 29

Priapism can be high flow or low flow- which type is typically associated with penile trauma?

Answer 29

High flow

Question 30

Priapism can be high flow or low flow- which type is more common?

Answer 30

Low flow

Question 31

Priapism can be high flow or low flow- which type is painful?

Answer 31

Low flow

Question 32

How can you distinguish between high or low flow priapism?

Answer 32

Aspiration of the corpus cavernosa

Question 33

How is low flow priapism treated?

Answer 33

Aspiration

Question 34

What is Fournier's gangrene?

Answer 34

Necrotising fasciitis occurring around the male genitalia

Question 35

How is Fournier's gangrene managed?

Answer 35

Antibiotics and surgical debridement

Question 36

What are some commonly prescribed drugs which may cause erectile dysfunction as side effects?

Answer 36

SSRIs, thiazide diuretics, beta blockers

Question 37

What class of drug is most commonly prescribed for erectile dysfunction?

Answer 37

Phosphodiesterase-5 inhibitors