CMS III Final: URO

Incontinence d/t increased abdominal pressure

Stress

Overactive bladder

urge incontinence

1st and 2nd line tx for urge incontinence

1. Anticholinergics

2. Alpha blockers / Mirabegron

Who is overflow incontinence common in?

Men with BPH

How do diagnose a communicating hydrocele

Scrotal US

Where does the fluid come from in a communicating vs non communicating hydrocele

Communicating: peritoneal fluid

Non: mesothelioma lining of tunica vaginalis

Bag of worms

Varicocele

Grades of varicoceles

1: palpable with valsalva

2: palpable w/o valsalva

3. Visible

MC side of varicocele

Left (d/t inc pressure of L renal vein)

What causes right sided varicoceles

Pressure prob with IVC

Where are spermatoceles located

head of epididymis (typically posterior)

Blue dot sign

Appendage torsion

Tx of epididymitis in men <39

Rocephin + doxy

Management of paraphimosis

Manual reduction by squeezing the glans

Can admin mannitol / sucralose

When should surgery for hypospadias be done?

6-18 months old

What is Peyronie's disease associated with?

Dupuytren's contracture

Tx of priapism

Phenylephrine injection

Pt presents with inflamed glans and urethral discharge, how do you treat

Rocephin + doxy

GS DX of bladder CA

Cystoscopy and BX

Painless gross hematuria

bladder cancer

Management of bladder cancer stages CIS-T1

TURBT

Management of bladder cancer T2 & 3

Radical Sx or TURBT + chemo

Management of bladder cancer T4 and up

Chemo with MVAC

Staging of bladder cancer

CIS: CA in situ

Ta: epithelium

T1: laminate propria

T2: muscularis

T3: fat

T4: adj organs

MC neoplasms in men 20-35

Testicular CA

MC type of testicular cancer

Seminoma

AFP NOT ELEVATED

How is a prostate biopsy graded?

Gleason score

When should you screen for prostate cancer according to AUA

High risk: 40

No risk: 45-50

MC type of penile cancer

SCC

Staging of penile cancer

1: glans

2: shaft

3: operable nodes

4: non operable

Pt presents with an AUA / IPSS score of 6, how should you manage?

Mild: Watchful waiting

Mild: 0-7

Mod: 8-19

Severe: 20-35

Patho behind BPH

Cell proliferation

Inc epithelial / stromal cells

Treatment of BPH

Alpha blockers (-osins)

5α Inhibs (-asteride)

PDE5 w/ ED

Outpatient management of acute bacterial prostatitis

Bactrim / Cipro

Inpatient: ampicillin + Genta

Oligospermia

<15 million

How long do you have to try to conceive before its considered infertility

One year

When do PDE5s need to be taken?

Within 1 hr

Pt education before semen analysis

Abstinent for 72 hrs

When does a semen analysis need to be analyzed by?

1 hr

Side effects of tamsulosin

-orthostatic hypotension

-floppy iris

-retrograde ejaculation

-congestion

-weakness

What TX can be injected into the cavernosa for ED?

-alprostadil

-phentolamine

-Papaverine

Hypospadias occurs on what side of the penis

Ventral