Men's Health.....Part II.

We'll continue with health issues specifically affecting men, that you are very likely to
encounter on your board examination and in the clinical setting.


Q: Why is TESTICULAR TORSION an urologic emergency?


A: As in any condition with arterial circulatory compromise...time is golden.
Testicular salvage is 80-100% at within 8 hours and ZERO percent at 12 HOURS.




Q: What is the BEST immediate procedure of choice for treatment of torsion?



A: MANUAL DETORSION... by rotating the testis outward offers a 30-70% chance of
restoring arterial blood flow,,, with immediate PAIN RELIEF being the best guide.




Q: What is the MOST COMMON AGE GROUP for occurence of torsion?


A: The AGES of 12-18 YEARS. It is uncommon after age 30.




Q: What is ORCHITIS?



A: It is an INFECTION of the testes....usually under the age of 10. The MOST COMMON
cause is VIRAL....typically MUMPS.




Q: What is PRIAPISM?



A: It is a painful, continued ERECTION lasting greater then 4 hours.



Q: What is the MOST COMMON CAUSE?



A: Today....DRUG THERAPY for erectile dysfunction is the primary cause. In the past
ischemic (venoocclusive) was the most common cause...due to decrease or absence
of cavernous blood flow. E.g. Sickle Cell Crisis or pelvic vascular thrombosis.




Q: What is the BEST MEDICAL THERAPY?



A: Immediate application of ICE PACKS....then ORAL TERBUTALINE 5mg.
If this fails....an alpha AGONIST like PHENYLEPHRINE is injected.




Q: What is EPIDIDIMYTIS?



A: It is an infectious process (usually bacterial) involving the epididymis.
It is IMPORTANT to REMEMBER that on the boards...AGE is the main CLUE
as to the cause.
Thus, UNDER AGE 35...the likely causative agents are STD's...primarily
Chlamydia Trachomatis and Nisseria Gonorrheae

OVER AGE 35...Gram Negative bacteria, such as E.COLI is the likely cause.




Thanks again for your time...we'll continue soon.