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Penile & Urethral Disorders Flashcards

(55 cards)

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1
Q

Disorders of the Urethra

A

Urethritis
Urethral stricture
Meatal stenosis
Hypospadius

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2
Q

Define Urethritis

A

Inflammation of the urethra

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3
Q

Causes of Urethritis

A 
Gonorrhea
Chlamydia
HPV
Herpes simplex
Idiopathic
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4
Q

Symptoms of Urethritis in Males

A

Dysuria
Itching or burning at the meatus
Hematuria/hematospermia
Urethral discharge

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5
Q

Symptoms of Urethritis in Females

A

Frequency
Dysuria
Suprapubic discomfort
Discharge

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6
Q

Diagnostics of Urethritis

A

UA & culture

NAATs

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7
Q

Treatment of Urethritis

A

Azithromycin
Doxycycline
Alternatives: erythromycin, levofloxacin/cipro
Treat partner
Use condoms
Avoid irritants: caffeine, citric juices, tomatoes
NSAIDs

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8
Q

Define Urethral Stricture

A

Narrowing of the urethra with slowing of the urine

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9
Q

Two Types of Urethral Stricture

A

Anterior: begins at the bulbar urethra & end at the meatus
Posterior: involves the membranous & prostatic urethra

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10
Q

Etiology of a Urethral Stricture

A

Trauma
Iatrogenic
Infection

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11
Q

Trauma Etiology of Anterior Urethral Stricture

A

Straddle injuries

Penetrating injuries

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12
Q

Trauma Etiology of Posterior Urethra

A

Urethral disruption from pelvic fracture

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13
Q

Iatrogenic Etiology of Urethral Stricture

A

Catheterization

Surgical

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14
Q

Infectious Etiology of Urethral Stricture

A

Gonococcal

Chlamydia

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15
Q

Presentation of Urethral Strictures

A

Slow stream
Decreased caliber
Post-void dribbling

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16
Q

Diagnosis of Urethral Strictures

A

Catheter
Cystoscopy
Retrograde urethrogram (RUG)

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17
Q

Treatment of Urethral Stricture

A

Urethral dilation
Direct vision intra-uthrotomy (DVIU)
Urethroplasty

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18
Q

Define Meatal Stenosis

A

Narrowing of the opening of the urethra at the tip of the penis

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19
Q

Causes of Meatal Stenosis

A

Swelling & irritation after newborn circumcision

Idiopathy

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20
Q

Symptoms of Meatal Stenosis

A

Spraying of stream
Bed wetting
Dysuria

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21
Q

Diagnosis of Meatal Stenosis

A

Physical exam

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22
Q

Treatment of Meatal Stenosis

A

Meatonomy

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23
Q

Define Hypospadius

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A

Congenital defect in which the opening of the urethra is on the underside of the penis

24
Q

Presentation of Hypospadius

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A

Spraying of urine
Having to sit down to void
Foreskin makes the penis look like it has a “hood”

25
Diagnosis of Hypospadius
Made at the time of birth with PE
26
Treatment of Hypospadius
Surgical repair (4-18 months)
27
Complications of Surgical Repair of a Hypospadius
Meatal stenosis | Fistula
28
Penile Disorders
``` Balanitis Phimosis Paraphimosis Peyronie's Disease Erectile Dysfunction ```
29
Define Balanitis
Inflammation of the glans penis | Uncircumcised men with poor hygiene most affected
30
Causes of Balanitis
Infectious: candida, chlamydia, pseudomonas, gonorrhea | Non-infectious: balanitis xerotica obliterans
31
Presentation of Balanitis
Pain Irritation Itching/Burning
32
PE Findings for Balanitis
Erythema/Edema Discharge Ulceration
33
Diagnosis of Balanitis
Culture discharge Wet mount Potassium hydroxide
34
Treatment of Balanitis
Retraction of foreskin/wash with soap & water Bacitracin if bacterial infection suspected Topical clotrimazole for candidal infection Circumcision
35
Define Phimosis
Inability to retract the foreskin over the glans due to narrowing constriction, or adhesions
36
Causes of Phimosis
Balanitis | Poor hygiene
37
Complications of Phimosis
Balanitis Paraphimosis Voiding problems Penile carcinoma
38
Presentation of Phimosis
Erythema Itching Discharge Pain with erection & intercourse
39
Treatment of Phimosis
Betamethasone cream 0.05% BID | Circumcision
40
Define Paraphimosis
Retracted foreskin becoming trapped proximal to the glans resulting in edema, inflammation, and pain
41
Treatment of Paraphimosis
Firm compression & manual reduction of the foreskin | Circumcision
42
Define Peyronie's Disease
Curvature of the penis, particularly during erections | Fibrosis & plaque formation of the tunica albuginea
43
Causes of Peyronie's Disease
Vascular trauma | Injury to the penis
44
Acute Phase of Peyronie's Disease
First 18-24 hours | Includes penile pain, some curvature, penile nodule, & inflammation
45
Chronic Phase of Peyronie's Disease
Characterized by stable plaque, penile angulation, & loss of erectile ability
46
Presentation of Peyronie's Disease
``` Penile pain Penile angulation palpable plaque Indentation in the shaft Decreased erectile dysfunction ```
47
Treatment of Peyronie's Disease if Diagnosed in the First 6 Months
Vitamin E Ibuprofen Colchicine
48
Treatment of Peyronie's Disease if Diagnosed After 6 Months with a Stable Plaque
Injection therapy | Surgery
49
Injection Therapy for Peyronie's Disease
Collagenase clostridiu histoyticum (Xiaflex) | Verapamil: breaks up scar tissue
50
Define Erectile Dysfunction
Inability to achieve or maintain an erection for satisfactory sexual performance
51
Risk Factors for Erectile Dysfunctino
``` HTN Smoking DM Hyperlipidemia Obesity Surgery: prostatectomy, lymph node dissection Meds: SSRIs, beta-blockers ```
52
Diagnosis of Erectile Dysfunction
``` International index of erectile function questionnaire Fasting glucose Lipid panel TSH Testosterone level ```
53
Treatment of Erectile Dysfunction
1st: lifestyle modifications 1st-line medications: phosphodiesterase type 5 inhibitors 2nd-line medications: alprostadil (Caverject), vacuum pump device, Muse intraurethrally 3rd-line: inflatable penile prosthesis
54
Phosphodiesterase type 5 (PDE5) Inhibitors for Erectile Dysfunction
Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra) Avanafil (Stendra)
55
SE of Phosphodiesterase Type 5 (PDE5) Inhibitors
Headache Flushing Rhinitis Abnormal vision

Urology (12 decks)

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