Ch 26. Male Genitals

Question 1

3 cylinder columns of tissues:

Answer 1

2 Corpora cavernos + 1 Corpora spongiosum

Question 2

Which testes is lower?

Answer 2

The left due to a shorter chord

Question 3

2 sites where hernias occur in males

Answer 3

Femoral canal

Inguinal canal

Question 4

Older Age

Answer 4

• Sperm production begins to decrease at 40 years
• Testosterone declines gradually after age 55 years
• Slower and less intense sexual response
• Sexual expression in later life
• Physical changes do not interfere with libido

Thinner greying pubic hair
Decreased penis size
Excoriation of scrotal skin

Question 5

Cultural and Social Considerations

Answer 5

• Circumcision of male infants

* HPV vaccine approved for boys and men

Question 6

Subjective: Penis

Answer 6

Frequency, urgency, and nocturia
Dysuria
Hesitancy and straining
Urine colour
Past genitourinary history
Penis: pain, lesion, discharge
Scrotum: self-care behaviours, lump
Sexual activity and contraceptive use
Sexually transmitted infection contact

Older adults
Prostate enlargement
Incontinence
Nocturia
Sexual function

Question 7

Principles of Interviewing Adolescent Male Patients

Answer 7

• Ask questions appropriate for a boy’s age, but be aware that norms vary widely
• Ask direct, matter-of-fact questions; avoid sounding judgemental
• Start with a permission statement (“Often boys your age experience…”)
• Try the ubiquity approach (“When did you…” rather than “Do you…”)
• “Open the door” to later conversation
• Around age 12 to 13 years…
• Who can you talk to…
• Boys around age 12 to 13 years have a normal experience…
• Teenage boys have other normal experiences and wonder if they are the only ones who ever had them…
• Often boys your age have questions about sexual activity.…
• Has a nurse or doctor ever taught you…
• Has anyone ever touched your genitals…

Question 8

Inspect/Palpate

Answer 8

Penis
Skin
Glans
Urethral meatus
Pubic hair
Urethral discharge
Shaft

Scrotum—Inspect and palpate
Skin
Testis
Epididymis
Spermatic cord
Any mass
Note characteristics
Transillumination

Inguinal lymph nodes
Horizontal chain along groin and vertical chain along upper inner thigh

Question 9

Check for hernia

Answer 9

Patient standing and straining down

Palpation technique: feel for lump when they go to push in the inguinal canal

Question 10

Found a mass

Answer 10

Tenderness?
Distal or proximal to testis?
Can you place your finders over it?
Is it reduced when the patient lies down?
Can you auscultate bowel sounds over it?

Question 11

Assessment with indwelling catheter

Answer 11

• What’s a normal amount of urine per hour? min 30mL/hr
• Monitor for signs and symptoms of catheter-acquired urinary tract infection
–>CAUTI: cloudy urine, smell, sediment in bag, discomfort around tube, delirum/change in cognition, vital sign changes
• Risk factors: prolonged catheterization, female gender, diabetes, malnutrition, old age, and impaired immunity
• Proper anchorage
• Tubing should be free of kinking
• Collecting bag, below bladder
• Urethral meatus is pink, smooth, no discharge

Question 12

Testicular Self-Examination

T.S.E

Answer 12

Any of the following changes should be reported:

• Lump on the testicle
• Painful testicle
• Feeling of heaviness or dragging in the lower abdomen or scrotum
• Dull ache in the lower abdomen and groin

T: timing, once a month
S: showering, warm water relaxes scrotal sac
E: examining, check for changes, report changes immediately

Question 13

Testicular Cancer Risk factors:

Answer 13

Age 15 to 49
Delayed descent of testicles
Family history
Abnormal development of testicle

Question 14

Causes of Urine colour and discolorations

Answer 14

Medication side effects
Melanin
Liver disease
Some foods
Blood in urine
Dehydration
Excess fluids
Hepatitis
Urinary tract infection
Kidney stones