GU2
Terms
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- Balantitis
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Inflammation of the foreskin
.. can cause fibrosis, or phimosis - Carcinoma In Situ (Bowen\'s Disease/Erythroplasia of Queyrat)
- associated with invasive carcinoma
- Condylomata Acuminata
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(Venereal Warts)
Increase risk of anal carcinomal if anus involved.
Cervical dysplasia +/- carcinoma in infected women - Epididymitis/orchitis
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Inflammation of epididymis and/or testes
E. coli, Klebsiella, Strep., Pseudo Viral (mumps) Trauma
Men - Fournier\'s Gangrene
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EMERGENCY
Crepitance due to air in soft tissue (from gas forming organisms), testes spared. CT can see air
Predisposing: DM, alcoholism, malnutrition
ABX and remove ALL infected fascia immediately
..can cause death - Herpes Simplex
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Viral infection involving type 1/2 herpes
Asymptomatic viral shedding persists 3 months post acute clinical presentation
- can cause infant death if mother has active lesions - Herpes Zoster
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Dermatomal distribution of painful vesicles due to varicella virus
tx: gamma globulin and steroids
may be associated with underlying malignancy - Hydrocele
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Serous fluid accumulation between parietal and visceral layers of tunical vaginalis w/in scrotum
transiluminate when large
tx: hydrocelectomy (best).. risk infection with aspiration - Leukoplakia
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Sharply defined white plaque
Tx: eliminate source of irritation
Possibly premalignant - Meatal Stenosis
- Due to infection, diaper rash in circumcised infants
- Paraphimosis
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Inability to replace foreskin over glans after retraction
Due to Phimosis - Penile Carcinoma
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Squamous cell type = most common
mass or ulceration failing to heal
Due to chronic irritation from smegma, viral (HPV 16)
Can cause penile loss and death - Peyronie\'s Disease
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Curvature of penis during erection
..due to aquired fibrous plaque formation at corpora
Tx: verapamil, K+, PABA - Phimosis
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Inability to retract foreskin proximal to corona of glans
Tx with circumcision
Can cause balanitis, UTI, increased risk of paraphimosis or penile carcinoma - Priapism
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Prolonged penile erection (not associated with arousal)
corpus spongiosum spared (cavernosa engorged)
Due to neurologic dz, leukemia, sickle cell disease, drugs (like trazodone)
Low flow - hypoxic, damaging, black blood - need angiocath + irrigate (with dilute phenylephrine) - Scabies
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Pruritic popular dermatitis
Papules with central crustin
Caused by mite (sarcoptes scabies)
Tx: 5% permethrin cream - Spermatocele
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Cystic mass containing sperm .. separate from testes
Transiluminates when large. Use US
Caused by rupture of vas or epididymis
No tx unless symptomatic - Testicular carcinoma
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Peaks at 15-35 (young cancer)
Germ cell tumors are majority
Seminomatous/nonseminomatous
Increased risk in those w/ history of cryptochidism
((DO not biopsy via scrotal approach!) - Tinea Cruris
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Fungal dermatitis at inner thigh and groin regions
\"jock itch\"
- Varicocele
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Dilation of pampiniform plexus (90% left sided)
..If it occurs on R side, need to R/O retroperitoneal mass!
Grade 1: palpable with valsalva
2: palpable w/o valsalva
3: visible through scrotal skin
Tx: spermatic vein ligation - Ectopic Sebaceous Glands
- *Variants of normal*
- Hirsutoid Papillomas
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*Variant of Normal*
- pearly penile papules