The NCCPA™ PANCE Genitourinary Content Blueprint penile disorders
Erectile dysfunction | Patient will present as → a 60-year-old man who presents to your clinic for evaluation of erectile dysfunction. His wife died 5 years ago and he would like to start dating again. He denies having any life stressors. He reports having no morning or night-time erections. His past medical history includes hyperlipidemia managed with medication and pre-diabetes managed with an active lifestyle and diet. Occurs when a man can't get or keep an erection firm enough for sexual intercourse
DX: Detailed history and examination, including a DRE and neurologic examination. Assess for signs of PAD
TX: Treat with phosphodiesterase 5 inhibitors Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra)
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Hypospadias/epispadias | Patient will present as → a healthy newborn male is undergoing routine examination, upon examination of the genitalia the urethral meatus is found located proximal to the tip of the glans on the ventral aspect of the penile shaft. (hypospodiasis) Epispadias is when the urethra opens onto the topside of the penile shaft
DX: Diagnosis is usually made during the newborn exam but imaging studies (excretory urogram) can aid in the diagnosis TX: Treatment is surgical repair, usually performed before 1-2 years of age
Hypospadias (more common than epispadias) is when the urethra opens onto the bottom (underside) of the penile shaft
DX: Diagnosis is usually made during the newborn exam but imaging studies (excretory urogram) can aid in the diagnosis TX: Treatment is surgical repair, usually performed before 1-2 years of age
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Paraphimosis/phimosis | ReelDx Virtual Rounds (Paraphimosis) Patient will present as → a 31-year-old male who presents to the ED with penile pain after intercourse. He states that his penis is swollen and very painful. His vital signs are normal. Physical exam is notable for edematous foreskin that does not reduce to its original position. Paraphimosis is an inability to return the foreskin to its normal position
DX: The diagnosis of paraphimosis is based upon clinical findings TX: Treat by applying firm circumferential compression to the glans with the hand - may relieve edema sufficiently to allow the foreskin to be restored to its normal position.
Phimosis is an inability to retract the foreskin
DX: The diagnosis of paraphimosis is based upon clinical findings TX: Treat with betamethasone topically, if no improvement circumcision |