Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UROLOGY > PENILE & URETHRAL DISORDERS > Flashcards

PENILE & URETHRAL DISORDERS Flashcards

(80 cards)

Start Studying
1
Q

Two columns of tissue that run along side the penis that helps with erections

A

CORPUS CAVERNOSUM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

⦁ Column of sponge-like tissue that runs along the front and ends at the glans
⦁ The urethra runs through here

A

CORPUS SPONGIOSUM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Runs through the spongiosum and helps evacuate semen and urine from the body

A

URETHRA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

urethritis is more common in __________

A

females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CAUSES OF URETHRITIS

A 
⦁	Gonorrhea
⦁	Chlamydia
⦁	HPV
⦁	Herpes Simplex
⦁	Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

most common causes of urethritis

A

⦁ Gonorrhea

⦁ Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

male symptoms of urethritis

A

⦁ dysuria
⦁ itching or burning at the meatus
⦁ hematuria / hematospermia
⦁ urethral discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

female symptoms of urethritis

A

⦁ dysuria
⦁ frequency
⦁ suprapubic discomfort
⦁ discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DIAGNOSIS OF URETHRITIS

A

UA & CULTURE

NAAT (for chlamydia & gonorrhea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TREATMENT OF URETHRITIS

A

Suspected gonococcal vs non-gonococcal.
intramuscular dose of ceftriaxone(250 mg)
Azithromycin 1g PO single dose
Doxycycline 100mg bid x 7 days
Alternatives
Erythromycin 500mg PO qid x 7 days
Levofloxacin/Cipro 500mg PO once daily x 7 days

So Rocephin for gonococcal
Azithro or Doxy for non-gonococcal

fluoroquinolones are coming out of favor though due to resistance

  • Treat partner
  • Educate about condom use
  • Avoid irritants
  • NSAIDS

***Bring pt back to re-test to assure pt is cured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A fibrotic band of tissue that renders the normal compliant urethral lumen inelastic

A

URETHRAL STRICTURE

Narrowing of the urethra with slowing of the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 types of urethral strictures

A

anterior & posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

anterior urethral stricture = from _______ to ______

A

from bulbar urethra to the meatus (from below the prostate to tip of penis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

posterior urethral stricture =

A

membranous & prostatic urethra (from bladder to prostate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most common cause of urethral stricture in developed countries

A

idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

causes of urethral stricture

A

o Idiopathic = most common cause of urethral stricture in developed countries

o Trauma
⦁ Anterior urethra = straddle injuries, blunt trauma, penetrating injuries
⦁ Posterior urethra = urethral disruption from pelvic fracture

o Iatrogenic
⦁ Catheterization - wrong size / traumatic
⦁ Surgical

o Infection
⦁ Gonococcal / Chlamydia (urethritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

traumatic causes of anterior urethral stricture

A

saddle injuries, blunt trauma, penetrating injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

traumatic causes of posterior urethral stricture

A

urethral disruption from pelvic fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

iatrogenic causes of urethral stricture

A

cath - wrong size / traumatic

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

infectious causes off urethral stricture

A

gonococcal / chlamydia (urethritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SYMPTOMS OF URETHRAL STRICTURE

A

⦁ slow stream
⦁ decreased caliber
⦁ post-void dribbling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

DIAGNOSIS OF URETHRAL STRICTURE

A
  • Uroflowmetry = cylindrical device that measures speed of urination
  • Ultrasound PVR
  • Catheter
  • Cystoscopy
  • RUG - Retrograde Urethrogram = inject dye to see path/look for obstruction to bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cylindrical device that measures speed of urination

A

uroflowmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

initial diagnostic test for urethral stricture

A

US PVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
urethral stricture treatment
- urethral dilation - DVIU - urethroplasty ⦁ urethral dilation (with calibers - insert larger & larger calibers through urethra - pt will need to continue with self-calibration) ⦁ DVIU = direct vision internal urethrotomy - use camera through urethra and carve out tissue in urethra ⦁ Urethroplasty = re-direct urethra to perineum - now has to sit down to pee as urethra is no longer coming out of penis. Increased risk of infection due to proximity to anus. This is the permanent long-term fix for urethral stricture
26
Narrowing of the opening of the urethra at the tip of the penis
MEATAL STENOSIS
27
CAUSES OF MEATAL STENOSIS
⦁ swelling & irritation after newborn circumcision ⦁ idiopathic ⦁ failed "spadias" repairs
28
SYMPTOMS OF MEATAL STENOSIS
⦁ spraying of stream ⦁ bed wetting ⦁ dysuria ⦁ spraying of stream** (narrowing at meatal opening but not at the rest of the urethra, so pressure ends up spraying everywhere
29
***SPRAYING OF URINE
meatal stenosis also hypospadias
30
DIAGNOSIS OF MEATAL STENOSIS
PHYSICAL EXAM
31
TREATMENT OF MEATAL STENOSIS
MEATONOMY subincision underneath the glans A meatotomy is a form of penile modification in which the underside of the glans is split
32
bed wetting
meatal stenosis
33
A congenital defect in which the opening of the urethra is on the underside of the penis
hypospadias
34
Hypospadias can occur anywhere between the _____ and the ___________________
glans and penile-scrotal junction
35
presentation of hypospadias
Spraying of urine Having to sit down to void Foreskin makes the penis look like it has a “hood” Urinary retention
36
locations of hypospadias
``` o Glanular o Subcoronal o Mid shaft o Penoscrotal (junction) o Midscrotal o Perineal ```
37
diagnosis of hypospadias
made usually at the time of birth with physical exam
38
treatment of hypospadias
surgical repair (4-18 months)
39
when is surgical repair for hypospadias done
4-18 months
40
surgical repairs for hypospadias
⦁ Magpi = for glanular hypospadias - consists of meatonomy & glanuloplasty ⦁ Snodgrass = can be used for both distal hypospadias as well as more proximal ones o complications = meatal stenosis & fistula
41
complications of Snodgrass repair (for hypospadias)
meatal stenosis | fistula
42
inflammation of the glans penis
BALANITIS
43
who is most affected by balanitis
uncircumcised men with poor hygiene
44
causes of balanitis
o infectious o non-infectious - drug-induced eruptions - derm-related (Behcets)
45
presentation of balanitis
⦁ pain ⦁ irritation ⦁ itching / burning
46
PHYSICAL EXAM OF BALANITIS
⦁ erythema / edema ⦁ discharge ⦁ ulceration
47
DIAGNOSIS OF BALANITIS
⦁ culture discharge ⦁ wet mount ⦁ potassium hydroxide (KOH) - check for yeast infxn
48
TREATMENT OF BALANITIS
⦁ retraction of foreskin / wash with soap and water ⦁ Bacitracin if suspect bacterial ⦁ Clotrimazole if candida infxn ⦁ Circumcision
49
The inability to retract the foreskin over the glans due to narrowing, constriction or adhesions
phimosis
50
in children, phimosis may _______________
resolve on its own
51
CAUSES OF PHIMOSIS
⦁ balanitis (infection/inflammation causes adhesions) | ⦁ poor hygiene
52
complications of phimosis
⦁ balanitis ⦁ paraphimosis (finally get foreskin retracted, then can't get it back up) ⦁ voiding problems (dribbling) ⦁ penile carcinoma
53
PRESENTATION OF PHIMOSIS
⦁ erythema ⦁ itching ⦁ discharge ⦁ pain with erection & intercourse
54
TREATMENT FOR PHIMOSIS
⦁ Betamethasone cream 0.05% BID - helps to soften the skin/break down adhesions ⦁ Circumcision
55
The retracted foreskin becomes trapped proximal to the glans
paraphimosis
56
in paraphimosis, The retracted foreskin becomes trapped proximal to the glans, leading to
edema inflammation pain
57
UNTREATED PARAPHIMOSIS CAN LEAD TO
ischemia of the glans and eventual gangrene
58
treatment of paraphimosis
⦁ Firm compression & manual reduction of the foreskin | ⦁ Circumcision
59
Curvature of the penis, particularly during erections
Peyronie's Disease
60
fibrosis & plaque formation of tunica albuginea
Peyronie's Disease
61
Causes of Peyronie's Dz
⦁ vascular trauma | ⦁ injury to the penis
62
usual age of Peyronie's dz
40-70
63
acute phase of Peyronie's dz
first 18-24 hours includes penile pain, some curvature, penile nodule and inflammation
64
chronic phase of Peyronie's dz
characterized by stable plaques, penile angulation and loss of erectile ability
65
presentation of Peyronie's dz
``` ⦁ penile pain ⦁ penile angulation ⦁ palpable plaque ⦁ indentation in the shaft ⦁ increased ED** ```
66
TREATMENT FOR PEYRONIE'S DISEASE
- if diagnosed in the first 6 months ⦁ vitamin E ⦁ ibuprofen ⦁ colchicine = (gout medication) - inhibits collagen formation - inhibits plaque formation and can actually help reduce plaques in some pts - after 6 months - have a stable plaque ⦁ Injection therapy - Collagenase clostridium histolyticum (Xiaflex) - for men with a palpable plaque and at least 30 degree curvature - Verapamil (CCB) = weekly injections x 6 weeks ⦁ Surgery
67
TREATMENT FOR PEYRONIE'S DZ IF IN FIRST 6 MONTHS
⦁ vitamin E ⦁ ibuprofen ⦁ colchicine = (gout medication) - inhibits collagen formation - inhibits plaque formation and can actually help reduce plaques in some pts
68
TREATMENT FOR PEYRONIE'S DZ AFTER 6 MONTHS
- after 6 months - have a stable plaque ⦁ Injection therapy - Collagenase clostridium histolyticum (Xiaflex) - for men with a palpable plaque and at least 30 degree curvature - Verapamil (CCB) = weekly injections x 6 weeks ⦁ Surgery
69
- the inability to achieve or maintain an erection for satisfactory sexual performance
ED
70
- The most common sexual problem in men
ED
71
PATHOPHYS OF AN ERECTION
- interaction between neurotransmitters, biochemicals, and a smooth muscle response - initiated by parasympathetic & sympathetic neuronal triggers - integration of physiologic stimuli of the penis & sexual perception/desire - Nitric oxide = produced from endothelial cells after parasympathetic stimuli triggers smooth muscle relaxation and arterial influx of blood - compression of venous return follows --> produces an erection
72
______________ triggers smooth muscle relaxation and arterial influx of blood
nitric oxide
73
nitric oxide is produced from
endothelial cells after parasympathetic stimuli the nitric oxide released is then what triggers smooth muscle relaxation & arterial influx of blood
74
risk factors for ED
``` ⦁ HTN ⦁ smoking ⦁ DM ⦁ hyperlipidemia ⦁ obesity ```
75
DIAGNOSIS OF ED
``` ⦁ International Index of Erectile Function Questionnaire ⦁ fasting serum glucose ⦁ lipid panel ⦁ TSH ⦁ testosterone level ```
76
Do NOT take PDE5-inhibitors with
NITRATES
77
1ST LINE TX FOR ED
lifestyle modifications PDE-5 inhibitors (phosphodiesterase 5-inhibitors) Sildenafil/Viagra Tadalafil/Cialis Vardenafil/Levitra Avanafil/Stendra
78
SE of PDE-5 inhibitors
HA flushing rhinitis abnormal vision
79
2nd line tx for ED
⦁ Alprostadil (Caverject) - vasoactive substance injected into corpus cavernosum ⦁ Vacuum pump devise ⦁ Muse intraurethrally - like a urethral suppository - injected into urethra
80
3rd line tx for ED
⦁ inflatable penile prosthesis

UROLOGY (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions