Male Genitalia Flashcards
Phimosis
- Foreskin can not be fully retracted over the glans penis
- Not problematic unless it interferes with urination, sexual function, make sure there is no adhesion
Hypospadias
Congenital displacement of the urethral meatus to the inferior surface of the penis
Can range from on the tip of gland, down to the scrotal sac/perineum
May need surgical intervention when young
Balanitis
- Inflammation of the glans penis
- Symptoms often evolve 3-7 days.
- Present as pain, tenderness, or itching associated with small red lesions on the glans and/or the prepuce.
- Lesions can be ulcerated or scaly.
- Thick foul smelling purulent exudate is often produced
- Etiology varies, usually candida, bacterial
- Usually found in uncircumcised males
Genital Herpes
uneven painful lesions- Shallow, small, painful ulcers on red bases suggest a herpes infection.
Initial infection- may be extensive.
Recurrent infections- usually confined to a small local patch
Chancre with Primary syphilis v. Chancroid
Chancre- painless, punch like, STI, hard raised edge
Chancroid- bacterial STI, pus, soft ragged edge, rare
Condyloma
Genital warts
- fleshy colored lesion on shaft or penis
- avoided by HPV vaccine
What needs to be noted from the scrotal exam?
Size Shape Consistency Tenderness Feel for nodules/masses
Hydrocele
- A non-tender, fluid-filled mass within the tunica vaginalis.
- It trans-illuminates,
- Examining fingers can get above the mass within the scrotum.
Scrotal Hernia
- Fingers can not get above the mass because bowel extends into the abdomen
- bowel comes into the inguinal canal
- Males: site where the spermatic cord exits the abdomen
Varicocele
- varicose veins of the spermatic cord, usually on the left.
- Feels like a soft “bag of worms”
- separates from the testis
- slowly collapses when the scrotum is elevated in the supine patient. (enlarged scrotum)
- Associated with Infertility
Scrotal Edema
- Pitting edema, bilateral
- Taut scrotal skin
- Uncomfortable
- Seen in: Heart failure, nephrotic syndrome
Acute Orchitis
- Testis acutely inflamed, maybe red scrotum
- Painful, tender and swollen
- Difficult to distinguish from epididymis
- Usually unilateral
- Causative agent viral, such as mumps, can lead to infertility
Acute Epididymitis
- Tender, swollen epididymis
- Scrotum reddened and the vas deferens inflamed
- Occurs in adults, Commonly with Chlamydia
- Coexisting urinary tract infection or prostatitis supports the dx
Testicular Torsion
EMERGENCY!- Can loose a testicle
- Twisting of the testicle on the spermatic cord
- Acute painful, tender, swollen testicle that is retracted upward, not always constant, can twist and untwist
- Scrotum, red and edematous
- No urinary symptoms
- Absent cremasteric reflex, testicle won’t retract when you pinch on skin of the thigh
What is a normal cremasteric reflex?
If you pinch the skin of the thigh => testicle will retract
