Mens health issues


MEN'S SEXUAL DYSFUNCTIONS  (Vascular, Neurogenic, Hormonal, Psychogenic) :
  • DIMINISHED LIBIDO
    • Causes: Medications (SSRI, Opiates), Depression, Alcohol, Fatique, Hypoactive Sexual Desire, Recreational Drugs, Relationship issues, sexual aversion disorder, systemic illness, testesterone deficiency
      • Hypoactive Sexual Desire:
      • Sexual Aversion Disorder:
  • Testesterone Deficiency: 
    Evaluation of the male with possible hypogonadism Up-To-Datem
  • ERECTILE DYSFUNCTION: 
      • Etiology
        • Pyschological (Perfromance Anxiety, Relationship Stress, Depression, Schizophrenia) 
        • Organic Cause (Hormonal, Neurovascular, Anatomical)
      • History: Assess at 2 levels
        • Medical Hx: DM, Hypogonadism, Excess Alcohol, Smoking, Recreational Drugs, Lack of exercise, Medications
        • Sexual Hx: Assess for Onset, Pattern (Libido, Erection, Ejaculation, Orgasm)
      • Physical Exam: Penile exam, secondary sexual characteristics, Testicular size, and consistency, DRE, BP, HR, BMI, Waist Circumference)
        • Lab
          • Treatment:
            • Lifestyle Modification
            • Pharmacotherapy at Primary Care
            • Other options at Secondary Care (Intracavernosal and Intraurethral PG, Vaccuum Erection Devices, Penile Prothesis Surgery)
          • Reference(s)
        •  EJACULATION ABNORMALITIES
         
        BPH
        • Symptoms:
          • Voiding Symptoms: 
            • Feeling of Incomplete Emptying
            • Intermittency
            • Weak Stream
            • Hesitancy
          • Storage Symptoms:
            • Frequency
            • Urgency
            • Nocturia
        • Diagnosis:
          • Enlarged Prostate on Physical Examination
          • Bothersome Lower Urinary Tract Symptoms (IPSS or AUASI)
          • No other identifiable causes for the symptoms
        • Differential Diagnosis:
          • UTI,
          • Neurogenic Bladder Dysfunction
          • Drug Induced Lower Urinary Tract Symptoms
          • Heart Disease with Nocturnal Polyuria
          • MSA (MSA can be confused in the initial stage with BPH as other symptoms often arise only later) NEJM 2015
        • Tests:
          • UA
          • Consider PSA Screening (Controversial)
        • Treatment:
          • Alpha Adrenergic Blocker
            • Non-selective
            • Selective Alpha 1 a
          • 5-Alpha Reductase Inhibitor
          • Antimuscarinic Drugs
          • Phosphodiesterase type 5 inhibitors
        • Reference
        STD in MEN
        Sexually Transmitted Infections in Men Primary Care Urology 2010


        Genital Lesion
        Case 2-2014: A 44-Year-Old Man with a Lesion on the Penis

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