Male Genitourinary Assessment Flashcards

1
Q

Health History Points (10)

A
  1. Urination Habits - Frequency, Urgency, Nocturia
  2. Dysuria
  3. Hesitancy and Straining - may be indicative of
    prostate enlargement compressing the urethra
    (when combined with needing to urinate after
    going)
  4. Urine Colour
  5. Past GU history - incontinence, kidney disease,
    medications
  6. Penis - pain, lesions, discharge
  7. Scrotum - lumps, swelling
  8. Sexual Activity and Contraceptive Use - concerns
    with performance
  9. STI contact - known STI contact, treatment
  10. STI Risk Reduction - precautions to reduce risks
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2
Q

Polyuria

A

excessive urination (6+ times per day)

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3
Q

Oliguria

A

diminished quantity of urination (<400mL/24h)

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4
Q

Urgency to Urinate

A

urge to urinate even when the bladder is not near maximum capacity
- may be indicative of infection or conditions
causing irritations, inflammation or obstructions

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5
Q

Nocturia

A

the urge to urinate is so strong that it wakes you up at night
- occurs together with frequency and urgency in urinary tract disorders

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6
Q

Dysuria

A

burning sensation with urination

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7
Q

True Incontinence

A

inability to control urination, urination occurs without warning

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8
Q

Urge Incontinence

A

involuntary urine loss from overactive detrusor muscle in the bladder
(excessive contraction of bladder muscles causes
increased urgency to void)

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9
Q

Stress Incontinence

A

involuntary loss of urine with physical strain, sneezing, or coughing
- increased intra-abdominal pressure + weakness
in pelvic floor muscles

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10
Q

Physical Exam Points:

A
  1. Inspection
  2. Palpation
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11
Q

Inspection and Palpation: Penis

A
  1. Penis - wrinkled, hairless, no lesions
    • palpate shaft between thimb and first 2 fingers =
      penis should be smooth, semi-firm, and
      nontender
    • hair distribution should be consistent with age
  2. Glans - smooth, no lesions, easy retraction of foreskin with ability to slide back to normal position
  3. Urethral Meatus - meatus edge should be central, pink, smooth and with no discharge
    • compress glans anteroposterior between the
      thumb and forefinger to palpate
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12
Q

Hypospadias

A

ventral location of the urethral meatus (in comparison to the normal medial positon)

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13
Q

Epispadias

A

dorsal location of the urethral meatus (in comparison to normal medial position)

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14
Q

Phimosis

A

inability to retract foreskin

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15
Q

Paraphimosis

A

inability to return the foreskin to its original position when retracted

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16
Q

Inspection and Palpation: Scrotum

A

ask the patient to hold their penis out of the way

Inspection - scrotal size dependent on temperature (smaller when cold, larger when warm), asymmetry is normal (left normally lower than right)

Palpation - the scrotal sac should slide easily, be smooth, movable, feel oval, firm and rubbery bilaterally –> tender to mild pressure

17
Q

Inspection and Palpation: Hernias

A

Bulging of internal organ or fatty tissue through an opening in the muscle anterior to it
- Inspect the inguinal region for a bulge as the
patient stands and as the patient strains down
→ normally none is present
- Palpate for bumps/ mass

18
Q

Older Adult Considerations

A
  • no end to fertility –> sperm production decreases
    ≥ 40 years old
  • gradual decrease in testosterone production ≥ 55
    years old = slower/ less intense sexual response
  • decreased amount of pubic hair, turns grey/while
  • decreased penis + testes size = less firm to
    palpation
  • decreased tone of dartos muscle = scrotum hangs
    lower
  • decreased rugae = pendulous look to scrotum