Male Genitourinary Assessment Flashcards
What is the significance of the inguinal canal and why is it important to assess this area in males?
The inguinal canal is where the testes descend in utero. It is important to assess this area in males to ensure that their testes actually descended.
What does the external genitalia normally look like?
A male should have scrotum and a penis
What genital development needs to be checked in newborns?
The inguinal canal needs to be assessed to ensure that the testes have descended
What is a Tanner’s developmental table for ?
The table is used to assess the sequence of puberty
How many stages are there in the Tanner table?
5
What is the first stage of the Tanner table?
Prepubertal
What is the second stage of the Tanner table?
Enlargement of scrotum and testes; scrotum skin reddens and changes in texture
What is the third stage of the Tanner table?
Enlargement of the penis (first the length); further growth of the testes
What is the fourth stage of the Tanner table?
Increased size of the penis with growth in breadth and development of glans; testes and scrotum larger; scrotum skin becomes darker
What is the fifth stage of the Tanner table?
Adult genitalia
How does the genitourinary system change in older males?
- Sperm production reduces at age 40, but they are still fertile till 80s-90s
- Penile size decreases, scrotal sac hangs lower, rugae decreases, testicle size decreases
- Slower erection, maintained longer, faster flaccidity after ejaculation
- Longer recovery period (12-24 hours opposed to 2 mins)
What is circumcision?
The removal of a males penile foreskin
Is circumcision recommended?
According to the Canadian Pediatric Society circumcision should not be performed
What advice would you give to a new mother about retracting the foreskin on her son for hygiene purposes?
- Clean foreskin with soap and water, do not forcibly retract foreskin
- When it retracts easily, the area underneath should be cleaned occasionally
- 3-4 years old should be taught to clean under foreskin
- Should be a part of a daily routine by adolescence
What is HPV?
- Human papilloma virus
- STD
- Common in sexually active males who do participate in unprotected sex
- Causes genital warts and is associated with cancer of the penis, anus, head and neck
What kinds of subjective symptoms may present when taking a genitourinary history?
- Frequency and urgency to urinate
- Dysuria (not able to urinate)
- Hesitancy, staining, dribbling (consider prostate)
- Past GU history
- Pain, lesions, discharge
- Scrotal self-care, lumps
- Sexual activity and contraceptive use
- STI contact
What is epispadius?
A rare type of malformation of the penis in which the urethra ends in an opening on the upper aspect (the dorsum) of the penis
What is hyopsadius?
An opening of the urethra is on the underside of the penis
What are normal palpation findings in male genitalia?
- Glans is smooth
- Foreskin retracts easily
- Shaft is smooth, and non-tender
- Testes: oval, firm, smooth, equal, feely movable, slightly tender
- Epididymis is softer, discrete, smooth and non-tender
- If a mass is felt, it can not normally be illuminated
- Cord should feel smooth and non-tender
What is a hernia?
A hernia occurs when an organ or fatty tissue squeezes through a weak spot in the muscle wall.
Where might hernias develop?
A hernia may develop in the inguinal area, causing there to be a mass on the groin
What advice would you give to young males about testicular self-exam?
- Self examine in a warm shower with soapy hands.
- Feel for any unusual lumps
- Painful testicles
- Heaviness or dragging in lower abdomen
- Dull ache in a abdomen/groin
- Do this at least once a month
- Common in males 15-49, it is rare and 100% treatable
What should a nurse assess when caring for a patient with an in-dwelling catheter?
- Bag anchored
- Tubing below bladder, no kinks
- Colour and quantity, sufficient (50mls/hr min)
- Meatus pink and smooth with no discharge
