Male genitalia and hernias

Question 1

What should you ask about with the male genitalia?

Answer 1

penile discharge or lesions, testicular or scrotal pain, swelling, redness, or lesions, trauma, history of STDs, prior penile/scrotal surgery

Question 2

If the patient has penile discharge or swelling, any lesions, what should you ask?

Answer 2

• changes the patient has noticed
• color, amount, associated symptoms of discharge
• sores or growths
• itching and presence of excoriations
• swelling/pain in testicles or scrotum

Question 3

What should you document regarding STIs?

Answer 3

• sexual orientation
• previous genital symptoms or past STIs
• sexual activity (many only consider penile)
• ask about concerns for STIs
• ask about associated symptoms (diarrhea, rectal pain, fever, abdominal pain, conjunctivitis, sore throat, anorectal itching/bleeding)

Question 4

What are you examining on the penis?

Answer 4

skin: any excoriations
prepuce: for any smegma, phimosis, paraphimosis
glans: look for ulcers, scars, nodules, signs of inflammation
urethral meatus; look for discharge, inflammation, signs of hypospadias
compress glans to open meatus for further inspection

Question 5

What is hypospadias?

Answer 5

birth defect where opening of urethra is not located at the tip of the penis

Question 6

What is Peyronie’s disease?

Answer 6

fibrous scar tissue that develops on penis that causes curved, painful erections

Question 7

What are you assessing in the scrotum and other contents?

Answer 7

assess size, shape, consistency, nodules, tenderness of testis, epididymis, spermatic cord

Question 8

What causes testicular torsion?

Answer 8

causes acute pain and swelling, loss of cremesteric reflex –> medical emergency!!!

Question 9

What’s a hydrocele?

Answer 9

fluid collection in tunica vaginalis, which covers the testicle

Question 10

What’s a varicocele?

Answer 10

enlargement of veins within the scrotum, “bag of worms” feeling

Question 11

What’s the inflammation of the epididymis?

Answer 11

epididymitis – swollen, red or warm scrotum, commonly unilateral pain and tenderness w/ gradual onset

Question 12

What’s important to diagnose/inspect groin hernias?

Answer 12

inguinal region for asymmetry or bulging with patient supine

Question 13

When should patients participate in a testicular self-exam?

Answer 13

• cryptorchidism
• hx of cancer in contralateral testis
• mumps
• inguinal hernia
• hydrocele in childhood
• family hx

perform a monthly self exam 15-35