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31 Cards in this Set
- Front
- Back
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What is epispadias?
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urethral meatus is located in dorsal aspect of penis
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When is there an increased risk of incontinence with epispadias?
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when defect is closer to penopubic junction
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What is the tx for epispadias?
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surgery to correct incontinence and extend urethra
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Is hypospadias or epispadias more common?
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hypospadias
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What is hypospadias?
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position or urethral meatus is located in ventral aspect of penis, scrotum, or perineum
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What increases the incidence of hypospadias?
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estrogens and progestins given during pregnancy
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What is phimosis?
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foreskin cannot be retracted behind the glans
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Most common cause of phimosis
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chronic infection from poor local hygiene
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Is phimosis seen most in circumcised or uncircumcised patient?
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uncircumcised
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Patients with phimosis may have a history of?
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diabetes, yeast infections, or lichen sclerosis
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MC type of cancer as a result of phimosis
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SCC under foreskin
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Tx of phimosis
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if infected, treat w. broad spectrum antimicrobial agent and then circumcision
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What is paraphimosis?
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foreskin has been left retracted behind the glans resulting in painful engorgement and edema of glans
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If not treated, what can paraphymosis result in?
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glandular ischemia with arterial occlusion and necrosis of the glans
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Patients with paraphimosis have had some degree of _____________.
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phimosis
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Tx for paraphimosis
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manual reduction-- firmly squeeze glans for 5 min to reduce tissue edema/decrease size and then draw forward over glans
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If paraphimosis cannot be reduced, what may be required?
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incision under local anesthesia with Abx afterwards and circumcision
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This is a fibrous plaque of the tunica albuginea that causes curvature of erect penis
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Peyronie's Disease
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Is there pain with Peyronie's when the penis is not erect?
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no pain when not erect
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Age group with Peyronie's
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middle aged and older men
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What does exam reveal in Peyronie's
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palpable dense, fibrous plaque of varying size usually near dorsal midline
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What can you do in addition to exam to determine the extent of deep plaques?
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US
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What other condition of the hands has Peyronie's Disease been associated with?
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Dupuytren's contracture of the tendons of the hand
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Tx for Peyronie's Disease
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50% spontaneously resolve; if in 1-2 years, they do not, surgery in only tx option
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"Steroids, iontophoresis, Vit E, topical CCB, and radiation are ""treatments"" used for what condition? "
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Peyronie's Disease
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What is priaprism?
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prolonged painful erection greater than 4 hours
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What is the cause of priaprism?
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60% idiopathic; not sexually related
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Other causes of priaprism besides idiopathic?
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leukemia, sickle cell dz, pelvic tumors, pelvic infections, penile trauma, spinal cord trauma, or certain meds
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What is the major abnormality in priaprism?
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physiologic obstruction of the venous drainage that builds up highly viscous poorly oxygenated blood within the corpus cavernosa leading to interstitial edema and fibrosis of the corpus cavernosum
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What type of priaprism is a true urologic emergency?
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ischemic priaprism
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What is tx for priaprism?
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corporal aspiration and irrigation with normal saline; surgery to decompress the corpora cavernosum with sludged blood evacuate through large needle placed in the glans; tx underlying medical conditions; NO ice packs
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