Male Genitalia and Hernias Flashcards
Indirect inguinal hernias
Develop at the internal inguinal ring, where the spermatic cord exits the abdomen; presents with a bulge near the external inguinal ring
Direct inguinal hernias
Arise more medially from weakness in the floor of the inguinal canal; associated with straining and heavy lifting; presents with a bulge near the internal inguinal ring
Femoral hernias
More likely to present as emergencies with bowel incarceration or strangulation
What causes a lack of libido?
May arise from psychogenic causes such as depression, endocrine dysfunction, or side effects of medications
What causes erectile dysfunction?
May be from psychogenic causes, especially if early morning erection if preserved; it may also reflect decreased testosterone, decreased blood flow in the hypogastric arterial system, impaired neural innervation, and diabetes
What is premature ejaculation?
More commonly seen in young men than older men; possible causes are medications, surgery, neurologic deficits, or lack of androgen.
What is reduced or absent ejaculation?
More commonly seen in older men; possible causes are medications, surgery, neurologic deficits, or lack of androgen.
What is the primary cause of lack of orgasm?
Psychogenic problems
What is a common symptom of gonorrhea?
Yellow penile discharge
What is a common symptom of non-gonococcal urethritis from Chlamydia?
White penile discharge
What are the symptoms of disseminated gonorrhea ?
rash, tenosynvitis, nonoarticular arthritis, and even meningitis
Sores and growths on penis
look for ulcers in syphilitic chancre and herpes; warts for HPV; swelling in mumps orchitis, scrotal edema & testicular cancer; pain in testicular torsion, epididymitis & orchitis
What can infections from oral-penile transmissions include?
Gonorrhea, chlamydia, syphilis & herpes
What can occur after anal intercourse?
symptomatic or asymptomatic proctitis.
Phimosis
A tight prepuce that cannot be retracted over the glans
Paraphimosis
A tight prepuce that, once retracted, cannot be returned; edema occurs
Balantitis
Inflammation of the glans
Balanoposthitis
Inflammation of the glands and prepuce
What can pubic or genital excoriations suggest?
Lice (crabs) or sometimes scabies
Hypospadias
Congenital, ventral displacement of the meatus on the penis
What occurs in gonococcal urethritis?
profuse yellow discharge; definitive diagnosis requires Gram stain and culture
What occurs in nongonococcal urethritis?
scanty white or clear discharge; definitive diagnosis requires Gram stain and culture
What is suggestive of urethral stricture or a possible carcinoma?
induration of the ventral surface of the penis
What is suggestive of periurethral inflammation that is secondary to a urethral stricture?
tenderness in the indurated area
What is suggestive of cryptoorchidism (undescended testicle)?
poor developed scrotum on one or both sides of testicles
Common scrotal swellings
indirect inguinal hernias, hydroceles, scrotal edema, and testicular carcinoma (rare)
Tender, painful scrotal swelling is present in what conditions?
acute epididymitis, acute orchitis, torsion of spermatic cord, or strangulated inguinal hernias
any painless nodules in testis must raise a possibility of what condition?
Testicular cancer, a potentially curable cancer with peak incidence between the ages of 15-34 years old
varicocele
indicated by multiple tortuous veins in spermatic cord area, usually on the left; may be palpable or even visible
Hydrocele of the cord
Indicated by a cystic structure in the spermatic cord
Chronically infected vas deferens
May feel thickened or beaded
Swelling evaluation by transillumination
Swellings containing serous fluid (hydroceles), light up with a red glow, or transilluminate. Those containing blood or tissue, such as normal testis, a tumor or most hernias do not transilluminate.
What is suggestive of a hernia?
A bulge that appears with straining
Can you hear bowel sounds over a hernia? Over a hydrocele?
Bowel sounds can be heard over a hernia but not over a hydrocele
What is an incarcenated hernia?
Content cannot be returned to the abdominal cavity
What is a strangulated hernia?
When blood supply to the entrapped contents is compromised. Suspect in presence of tenderness, nausea, and vomiting; consider surgical intervention
What is the most common form of cancer in men between ages 15-34 years old?
testicular carcinoma
