Male Genitalia

Question 1

When should a male genital exam be performed?

Answer 1

all well child exams

child sick visits (if indicated)

all adolescent well visits (until tanner stage V)

as indicated for late adolescent/adult men

Question 2

Most testicular cancers are what type?

Answer 2

germ cell tumors

Question 3

Who gets a routine testicular exam?

Answer 3

only for men with risk factors

Question 4

What is the order of the male genital exam?

Answer 4

1. Inguinal/pubic region
2. Hernia check
3. Penis/glans
4. Scrotum (sac, testes, epididymis, spermatic cord/vas deferens)
5. Rectal/prostate
6. Breast (as needed, based on history)

Question 5

How do you check for an inguinal hernia?

Answer 5

• Visually inspect
• Invaginate the index finger within the loose scrotal skin below the inguinal canal and directly alongside the spermatic cord
  
  • follow the spermatic cord through the neck of the scrotum at an angle coinciding with the inguinal canal
  • Ask the patient to bear down or turn his head and cough
  • Impulse felt at the tip of the finger indicates an indirect inguinal hernia
  • Impulse at the side of the finger is indicative of a direct inguinal hernia

Question 6

Which testical is typically larger? which is typically lower?

Answer 6

larger –> right

lower –> left

Question 7

What is a hydrocele?

Answer 7

fluid within tunica vaginalis

transillumination can help dx

painless

typically dx at birth and resolve within one year

if developed in adult, can be 2^o to testicular cancer

Question 8

What is the first step if testicular torsion is suspected?

Answer 8

must image or call surgeon right away –> don’t schedule scans for tomorrow…

Question 9

What are the sx of testicular cancer?

Answer 9

lump or enlargement

heaviness of scrotum

dull ache in abd or groin

sudden collection of fluid in scrotum

pain

gynecomastia

back pain