Male Genitalia Ano-Rectal Assessment

Question 1

Related Health History

Answer 1

Any urinary problem - dribbling, frequency, urgency, nocturia, trouble initiating stream, pain, burning,discharge 
Circumcised or not
Back pain 
STD history
Surgical History
Impotence or other sexual dysfunction
Bulges/Groin pain
Bleeding (GU or rectal)
Performs STE

Question 2

Priapism

Answer 2

Prolonged erection

Question 3

Risk factors

Answer 3

Employment history
Multiple partners
Sexual preferences
Safe sex practices
Testicular cancer - age 20-35, undescended testicle, testicular swelling with mumps, family history, white, upper social class, never marries, no STE

Question 4

Equipment

Answer 4

Gloves
Lubricant
Penlight/flashlight
Warm/private room
Drapes as needed
Have pt. void before and keep conversation clinical, do not ask history information at this time

Question 5

Male hair growth pattern

Answer 5

Diamond shape; coarse; curly; penis hair; few hairs on scrotum

Question 6

Phimosis

Answer 6

Skin cannot be retracted; causes problems with urination, requires surgery

Question 7

Paraphimosis

Answer 7

Skin can be retracted, but not returned to usual state; could end up strangulating the penis; be careful of this when giving baths especially in elderly patients
Always put foreskin back to prevent this

Question 8

Chancre

Answer 8

Syphilis sores

Question 9

Ulcerations

Answer 9

Frequent site for cancer

Question 10

Peyronies disease

Answer 10

Hard, non-tender, subcutaneous plaques on dora-medial surface; penile bending with erection and painful intercourse

Question 11

Cryptochridism

Answer 11

Undescended testicles since birth

Question 12

Normal epididymis, vas deferens, and veins/arteries

Answer 12

Located posterolateral in 93%; anterior in remaining 7%

Smooth, nontender, large tube with smooth cords and threads felt

Question 13

Variocele

Answer 13

Abnormal enlargement of the pampiniform venous plexus in the scrotum

Question 14

Hydrocele

Answer 14

Swelling in the scrotum that occurs when fluid collects in the this sheath surrounding a testicle

Question 15

Spermatocele

Answer 15

an often pain-free benign cysts that occurs close to a testicle

Question 16

Indirect Inguinal

Answer 16

sac herniates through internal inguinal ring; can remain in canal or pass into scrotum
Pain w/ straining; soft swelling that increases intra-abdominal presser; may decrease when lying down
Most common; 60% of all hernias; more common in infants <1 and males 16-20 years of age
Congenital

Question 17

Direct Inguinal

Answer 17

Directly behind and through external inguinal ring, above inguinal ligament; rarely enters scrotum
Usually painless; round swelling close to the pubis in area of internal ring; easily reduced when supine
Less common, occurs more in men > 40
Acquired weakness brought on by heavy lifting, muscle atrophy, obesity, chronic cough, or ascites

Question 18

Femoral Hernia

Answer 18

Through femoral ring and canal, below inguinal ligament, more often on right side
Pain may be severe; may become strangulated
Acquired; due to increased abdominal pressure, muscle weakness, or frequent stooping

Question 19

Urethritis

Answer 19

Inflammation of the urethra

White discharge