Aetiology Assessment Approach Investigations Management and Referral Management Overview of Haematospermia Key Points

Post-circumcision problems 

The tip of the foreskin or other skin (e.g. scrotum) may become entrapped in the teeth of a zipper Treatment: Give oral analgesia +/- sedation Cut median bar of zip slider with wire cutters – #1Cut across zipper with wire cutters – #2Separate zip teethAlways check for injury to the glans…

    Lifelong (primary) Acquired (secondary) Variable Subjective IELT criteria <1 minute <3 minutes Short or normal Normal or prolonged Symptoms Ejaculation occurs too early in nearly every sexual encounter New onset of premature ejaculation, usually the result of an identifiable source and patient has experienced normal ejaculations in the…

Definition: Twisting of the spermatic cord leading to decreased blood flow to the testicle resulting in ischemia, infarction and potentially, tissue necrosis. Epidemiology: Pathophysiology:  Differential Diagnosis Clinical Presentation “No discriminating features, in either history or examination conclusively differentiate the correct diagnosis”  History Physical Examination Diagnosis Ultrasound Images of Torsion Right…

Classification Risk factors  No need for USS prior to referral Treatment Prognosis

Balanoposthitis in adult males

Refers to the condition when the foreskin (prepuce) cannot be retracted over the glans penis. May be physiologic  Due to normal adhesion of the foreskin to the glans.  Common in male children up to 3 years of life. Can be seen even into the teenage years. Does not require surgical…

Epidemiology of Erectile Dysfunction (ED) Pathophysiology of Erectile Dysfunction (ED) Aetiological factors are multimodal Multifactorial Causes Cardiovascular Disease and Erectile Dysfunction Correlations with Other Conditions History Key Questions in the Assessment of Erectile Dysfunction Define Sexual Function Duration of the Erection Numbness or Unusual Sensations in the Penis Loss of…

Commonly Misused Steroids Oral Steroids Injectable Steroids Mechanism of action Administration The apparent positive effects of anabolic steroids include gains in muscular strength (in conjunction with diet and exercise) and quicker healing of muscle injuries. However, the adverse effects, which are dependent on the dose and duration, are numerous. Adverse…

Aetiology of haematospermia Infection (in the form of prostatitis, urethritis, epididymo-orchitis): Bacterial – chlamydia, gonorrhoea, enterococcus, tuberculosis Viral – human immunodeficiency virus (HIV), cytomegalovirus (CMV), herpes simplex virus (HSV) Other – schistosomiasisIatrogenic Post-transrectal ultrasound (TRUS) biopsy Prostate radiotherapy or brachytherapy Post-vasectomy Post-orchidectomyMalignancy Prostate Bladder Testicular UrethralTrauma Coital trauma Perineal traumaProlonged abstinenceObstruction…

Andrology Australia https://www.andrologyaustralia.org/wp-content/uploads/Factsheet_Vasectomy.pdf As a general rule, the only lumps you should ever find inside your scrotum are your testicles. Regardless of whether or not you’ve had a vasectomy, any unidentified mass should be checked examined by a doctor immediately Post-Vasectomy Conditions 1. Sperm Granuloma 2. Scrotal Hematoma 3. Lumps…

genital warts  Distinguishing characteristics of a genital wart compared to a normal anatomical variant   Wart likely Normal anatomical variant likely History   UnvaccinatedSexual contact with genital warts   Previous quadrivalent-HPV vaccination, especially if given before the commencement of sexual activity   Appearance         Irregular Rough Asymmetrical…

Causes of epididymitis Sexually active men <35 years of age Chlamydia trachomatisNeisseria gonorrhoea Men >35 years of age Coliform bacteria (Escherichia coli) Children EnterovirusesAdenovirusesMumpsE. coli Chronic infection Mycobacterium tuberculosisMany of the above untreated Immunocompromised Cytomegalovirus (CMV)CryptococcusPseudomonas aeruginosaKlebsiella pneumoniae Rare Ureaplasma urealyticumCorynebacterium spp.Mima polymorphaProteus mirabilisBrucellaTreponema pallidumFilariasis Non infectious SarcoidosisBehcet’s diseaseAmiodaroneIdiopathicPolyarteritis nodosa Clinical features Investigations treatment Empirical antibiotics: PLUS…

(This type of hydrocele tends to be small, with the exception of secondary hydrocele due to filariasis, which can be very large) Etiology History and Physical Examination: differential diagnosis. Treatment / Management

Signs and symptoms in the classic case   Symptoms Signs Testicular torsion Sudden onsetSevere painAssociated nausea and vomitingAssociated traumaPossible abdominal pain Asymmetric, high-riding testisNegative Prehn’s signAbsent cremasteric reflex Epididymitis Insidious onsetFevers and rigorsLower urinary tract symptomsRelevant sexual history Indurated testisTender upper pole of testisPositive Prehn’s signIntact cremasteric reflex Torsion of…

Symptoms of prostatitis Acute bacterial prostatitis Clinical investigations Treatment Complications Chronic bacterial prostatitis chronic prostate pain syndrome

History Exam Evaluation minimal assessment includes: FSH LH Testosterone Prolactin Hypogonadotropic hypogonadism Low Low Low Normal or high Abnormal spermatogenesis High or normal Normal Normal Normal Testicular failure or hypergonadotropic hypogonadism High High Low Normal Prolactinoma Normal or low Normal or low Low High Hypogonadotropic hypogonadism Hypergonadotropic hypogonadism: Decreased functional…

can lead to bladder outlet obstruction in some patients, which may cause urinary retention (acute or chronic), recurrent UTIs, hydronephrosis, or renal injury Risks  Differentials Differential diagnoses for lower urinary tract symptoms (LUTS) Benign and neoplastic conditions of the lower urinary tract Neurological conditions Other causes of lower urinary tract symptoms…