The Male Reproductive Tract

Question 1

What conditions affect the prostate?

Answer 1

• Benign prostatic hyperplasia. - Prostate cancer.

Question 2

What is benign prostatic hyperplasia?

Answer 2

• Common - increase in number of cells resulting in the formulation of nodules, prostate weighs heavy. - symptoms - increased frequency, hesistency, nocturia, terminal dribbling. Increased risk of infection and enlarged prostate. - If small and asymptomatic then conservative, reduce fluid intake at night, reduce alcohol and caffeine, scheduled voiding. - Medical treatment - alpha-blockers, reduces the smooth muscle tone in the prostate.

Question 3

What is prostate cancer?

Answer 3

• Age, race, family, history, hormone levels and diet are risk factors. - Symptoms - may be asymptomatic, nocturia, hesitancy, poor stream and dribbling, exam shows hard, irregular prostate. - Diagnosis - raised prostate specific antigen and biopsy. - Treatment - depends on stage, local disease can be treated with radical prostatectomy, HRT and radiotherapy.

Question 4

What disorders affect the testis?

Answer 4

• Testicular torsion. - Testicular tumours.

Question 5

What is testicular torsion?

Answer 5

• Sudden onset of pain in 1 testis. - Pain in abdomen, nausea and vomiting. - Testis is hot, swollen and tender. - The testis may lie high and transversely. - Most common in 11-30yrs old. - Tests - USS with Doppler but may need exploratory surgery. - Treatment - surgery (urgent), if still viable bilateral fixation (archidopexy) if abnormal then orchidectomy.

Question 6

What are testicular tumours?

Answer 6

• Most common malignancy in males aged 15-44yrs old. - Risk factors - undescended testis, infant hernia and infertility. - Presentation - painless testicular lump often noted after trauma or infection. - Germ cell tumours. - Treatment - depends on type of tumour and stage. Usually involves on orchidectomy and a combination of radio/chemotherapy.