Urology

Prostate Disorders

BPH Etiology 80% by 80y Does NOT cause prostate cancer Presentation Hesitancy, frequency, weak stream… Opening hematuria Diagnosis DRE Uniform enlargement Rubbery texture U/A, UC Initial PSA recommended but correlate clinically Post-void residual → >50 ml Treatment α blocker Tamsulosin Terazosin Prazosin Doxazosin 5α reductase inhibitor Finasteride Dutasteride Antimuscarinic → ↓ Overactive...

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Erectile Dysfunction

Erectile Dysfunction Classification Failure to initiate Psychological → Nocturnal erection is ok Endocrine Neurologic Failure to fill Arterial Failure to store Veno-occlusive Etiology DM Atherosclerosis Drugs Beta blockers SSRI TCA Diuretic Hypertension Heart disease Prostate cancer surgery/radiation Spine injury Treatment Psychotherapy PDE5 inhibitors Sildenafil Vardenafil Tadalafil Side effect +...

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Scrotal Swelling

Scrotal Swelling Painless Hydrocele Transilluminates Types Non-communicating No change in size Communicating ↑ in size with valsalva Patent processus vaginalis Resolves spontaneously ↑ Risk of indirect inguinal hernia Varicocele Bag of worms above testis Left > Right Does NOT transilluminate ↑ in size with valsalva No need to treat...

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Urologic Cancers

Simple renal cyst → Incidental finding, No treatment needed, Reassurance only Renal Cell Carcinoma Adenocarcinoma Etiology Male Smoking Obesity Cysts due to ESRD von-Hippel-Lindau Angiomatosis Visceral cysts RCC CNS tumors Presentation Triad Hematuria Flank pain Flank mass LEFT-SIDED varicocele Fever Malaise ↓ Weight Anemia 5-10% → Polycytemia Diagnosis Best initial →...

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