Mens Health Priapism
painful erection for 204 hours, ischemi form is medical/surgical emergency
Testicular cancer
hard fixed, nodule, heaviness
... [Show More] or aching, one testicle larger than other, hydrocele from tumor, painless asymptomatic until Metz, DX gold standard testicular biopsy, US of testes, refer to urology, for surgical removal (orchiectomy)
Prostate Cancer
most common cancer in men, new onset of low back pain, rectal perianal area, obstructive voiding symptoms, weak stream, nocturia, risk factor obese and family history, >50 years old, DX routine screening not recommended
Torsion of the appendix testes
blue dot sign, blue colored round mass located on testicular surface, polyp like structure attached to testicular surface, infarction and necrosis of the appendix due to torsion, refer to ER
Testicular torsion
abrupt onset extremely painful and swollen red scrotum, n/v, affected testes higher and closer to body, the cremasteric reflex is missing, > not corrected in <6 hours permanent damage, if not corrected in 24 hours becomes gangrene, common in males with bell clapper deformity, TX call 911, US doppler preferred test, manual reduction or surgery, elevated PSA, biopsy of prostate tissue, PSA level with DRE TX refer to urologist, individualize screen per risk factors
Varicocele
enlargement of the veins within the scrotum, bag of worms, testicular tumor can cause infertility, DX US of scotum, TX surgical removal or varicosities
Hydrocele
fluid filed sac around testicle, swelling of scrotum, asymptomatic, DX will glow with transillumination, US of scrotum, TX refer to urologist
Direct inguinal hernias
are found in the Hesselbachs triangle
indirect inguinal hernia
are common on the right side internal ring
Cryptorchidism
a testicle that has not moved into the bag of skin below the penis before birth, maybe one or two, increases risk of testicular cancer
BPH
gradual development of urinary obstruction, weak urinary stream, postvoid dribbling, occasional urinary retention, DX PSA is elevated, prostate enlarged, TX alpha adrenergic antagonist-terazosin/Hytrin-first for patients with HTN, Flomax, or Proscar shrinks prostate by 50%
Chronic bacterial prostatis
>6 weeks infection, gradual onset, asymptomatic or UTI,caused by E.coli, suprapubic or perineal pain, irritative voiding, dysuria, nocturia, frequency, DX boggy prostate, urine and prostatic fluid cultures, three tubes, PSA elevated, TX Bactrim, fluoroquinolone
Acute prostatis
infections ascends to urinary tract, E.coli, sudden onset of high fever, chills, suprapubic pain perineal discomfort, radiates to back to rectum, UTI, symptoms, DX DRE reveals tender prostate warm and boggy, CBC shows leukocytosis, pyuria, urine culture, TX Ceftriaxone tetracycline, macrolide, fluoroquinolone, refer if septic shock
Acute bacterial epididymitis
bacteria ascend the urethra, urethritis, reaching epididymitis, rule out testicular torsion, E coli, swollen red scrotum, unilateral testicular tenderness with urethral discharge, hydrocele with symptoms of UTI, fever, green colored purulent or serous clear discharge, Prehn's sign positive with relief of srotal elevation, DX leukocytosis pyuria, hematuria, Urine culture, test for gonorrhea/chlamydia TX ceftriaxone, doxycycline, or fluoroquinolone
Erectile dysfunction
d/t vascular insufficiency, neuropathy, medications, smok,ing alcohol, TX first line TX [hosphodiesterase type 5 inhibitor, Viagra Levitra
Peyronie's disease
inflammatory disorder of the penis with firbrotic plaques on the tunica albuginea, penile pain during erection, palpable nodules cause deformity penile erections, may resolve or require surgery, TX refer to urologist [Show Less]