Male Genitalia: Hernias and Abnormal Findings

Question 1

What exam findings are consistent with a hernia in the newborn infant?

Answer 1

Scrotal mass that is separate from the testes, usually reducible, and often does not transluminate. They do not resolve. Sometimes a thickened spermatic cord (silk sign) is noticed

Question 2

Exam findings consistent with a hydrocele.

Answer 2

Non-tender, fluid filled mass within the tunica vaginalis of the scrotum - overlie the testes and the spermatic cord and are not reducible - transluminate and examining fingers can palpate above the mass within the scrotum - resolve by 18 months

Question 3

What is hypospadias?

Answer 3

Congenital displacement of the urethral meatus to the inferior surface of the penis

Question 4

What is chordee?

Answer 4

A fixed downward bowing of the penis - may accompany hypospadias

Question 5

What are some benefits of circumcision?

Answer 5

• easier hygiene
• decreased risk of UTIs
• decreased risk of STIs/HIV
• prevention of penile problems/phimosis
• decreased risk of penile cancer

Question 6

Indirect inguinal hernia

Answer 6

Originates above the inguinal ligament near its midpoint and comes down the inguinal canal often into the scrotum - can occur in all ages and both sexes, often in children - may occur in adults

Question 7

Direct inguinal hernia

Answer 7

Oriniates above the inguinal ligament close to the pubic tubercle (near the external inguinal ring) and bulges anteriorly - rarely into the scrotum

Less common - usually in men < 40 years old - rare in women

Question 8

Symptoms and exam findings with a testicular torsion

Answer 8

• Acutley painful, tender, and swollen organ that is often retracted upward into the scrotum
• Absent cremasteric reflex
• If presentation is delayed, scrotum becomes red and swollen
• Most common in neonates and adolescents, but can occur at any age
• Is a surgical emergency because of obstructed circulation

Question 9

A testis that does not reside in and cannot be manipulated into the scrotum

Answer 9

Cryptochidism

Question 10

During a newborn male assessment, you observe swelling in the right scrotum that overlies the testes and spermatic cord that can be transluminated. You discuss with the patient’s parents that this is likely:

Answer 10

a hydrocele

Question 11

These types of hernia develop at the interanl inguinal ring, where the spermatic cord exits that abdomen.

Answer 11

Indirect Inguinal Hernias

Question 12

A 26yo male presents with yellow penile discharge, rash, tenosynovitis, and monoarticular arthritis. What is the most likely pathogen?

Answer 12

Gonorrhea

Question 13

If suspecting a testicular torsion, which reflex should the FNP assess for?

Answer 13

Cremasteric Reflex

Question 14

A newborn presents with a scrotal mass that transilluminates. What finding is this most consistent with?

Answer 14

Hydrocele