Peyronie disease
Abnormal curvature of penis d/t fibrous plaque within tunica albuginea.
Common condition (affecting ~5% of men) that arises d/t repetitive blunt trauma to the penis during sexual intercourse with subsequent aberrant wound healing.
Active or progressive
Often require NSAIDs for pain
Pentoxifylline to reduce fibrosis; and/or intralesional injections of collagenase
Surgery may be indicated in refractory cases.
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Varicocele
- m/c, ??? ??. ?? ??? ?? ???? ?? ?
- Clinical presentation
- Soft scrotal mass
- ?in supine position
- ?with standing/Valsalva maneuvers
- Subfertility
- Testicular atrophy
- Soft scrotal mass
- Ultrasound findings
- Retrograde venous flow
- Tortuous, anechoic tubules adjacent to testis
- Dilation of pampiniform plexus veins
- Treatment
- Gonadal vein ligation (boys & young men with testicular atrophy)
- Scrotal support & NSAIDs (older men who do not desire additional children)
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Testicular rupture; Sperm ?? ????? auto-Ab ??. ???? ??? ?.
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Erection? physiology
Vascular
Neuronal
Hormonal
Emotional
Impotence
| Common causes | Clinical features |
| Vascular | Smoking |
| Neurologic | DM |
| Psychogenic | Normal nonsexual nocturnal erections |
| Endocrine |
|
| Medications |
|
| Hypogonadism |
|
???: PDE5 ihn. (sildenafil-Viagra)
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Penile erection
Vasectomy
Viable sperm remain in the portion of the vas deferens distal to the ligation.
At least for 3 months, 20 ejaculates.
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