Ch 26 Male GU

Question 1

Columns of penile erectile tissue

dorsal: ______
ventral: ______

Answer 1

Dorsum: corpora cavernosa x 2
Ventral: corpus spongiosum

Question 2

testicle

size and function

Answer 2

size: 3x4x5 cm (think Lalya!)
function: make sperm and testosterone

Question 3

lymphatic vessels of penis and scrotal surface drain to ______
lymphatic vessels of testes drain to ______

Answer 3

penis and scrotal surface: inguinal

testes: abdomen

Question 4

first sign of puberty is:

Answer 4

enlargement of testes –> pubic hair –> penis

Question 5

Potential health benefits of circumcision

Answer 5

• reduced incidence of UTI
• eliminates need for circumcision if recurrent balanitis, phimosis, paraphimosis
• lower risk of penile cancer
• lower risk of STIs (including HIV, HSV, HPV)
• female partners lower risk of trich, BV, cervical cancer

Question 6

some causes of nocturia

Answer 6

• cardiovascular
• DM
• habit
• diuretics

Question 7

Define:

• phimosis
• paraphimosis
• hypospadias
• epispadias

Answer 7

phimosis: inability to retract foreskin
paraphimosis: inability to return foreskin to original position emergency*

hypospadias: ventral (under) location of meatus
epispadias: dorsal (upper) location of meatus

Question 8

Transillumination will show serous fluid in _____ and _____
Serous fluid will illuminate ____ (colour)

Transillumination will not occur in _____ , ____ and _____

Answer 8

hydrocele
spermatocele

• will illuminate red
• will not occur in hernias, epididymitis or tumours

Question 9

Peyronie’s disease

• signs and symptoms
• cause
• risk factors

Answer 9

hard, nontender, subcutaneous palques on dorsal/lateral surface of penis
-painful bending of penis during erection
-plaques are fibrosis of corpora cavernosa
-usually after 45+, trauma to erect penis
Risk factors: DM, gout, Dupuytren’s contracture

Question 10

Testicular torsion

Signs and symptoms

Answer 10

-usually on L side
S: excruciating pain, sudden onset
-abdo pain/nausea/vomiting. no fever
O: swollen red scrotum, one testicle is higher than other, cremasteric reflex absent
**medical emergency

Question 11

Epididymitis

Signs and symptoms

Answer 11

• sudden onset scrotal pain
• relieved by elevation (Phren’s sign), rapid swelling and fever

O: swollen red scrotum, exquisitely tender epididymis

difficult to differentiate between epididymitis and testicular torsion

Question 12

Varicocele

signs and symptoms

Answer 12

-usually L side
-varicose veins in spermatic cord
-dull pulling/dragging pain or asymptoamtic
-“bag of worms”
soft irregular mass palpable posterior above testicle, collapse when pt supine

Question 13

Spermatocele

signs and symptoms

Answer 13

painless
transillumination
freely movable mass above and behind testes

Question 14

most important risk factor for testicular cancer

Answer 14

undescended testicle

Question 15

hydrocele

signs and symptoms

Answer 15

painless swelling (sometimes will say heavy)
transillumination
nontender mass

Question 16

scrotal hernia

signs and symptoms

Answer 16

• cannot be transilluminated
  -swelling and pain with straining
• usually from indirect inguinal hernia
• may be reduced in supine position