MALE GU Flashcards
Renal pain cause
distension of the renal capsule
i.e. renal stone, acute pyelonephritis, hydronephrosis
renal pain described as dull and constant:
infection
renal pain described as waxing & waning:
obstruction
location/radiation of renal pain
costovertebral angle (CVA) ; often spreads to the umbilicus or lower abdominal quadrant
Assoc. Sx of renal pain:
nausea, vomiting
Ureteral pain causes:
acute obstruction/ distension of the ureter due to stone or clot
ureteral pain described as: Constant, dull:
distension
ureteral pain described as: Colicky:
spasm
Location & radiation of ureteral pain:
Proximal ureter: radiates to ipsilateral scrotum (labium in F)
Mid-ureter: radiates to lower abdominal quadrant
Distal ureter: also causes urinary urgency and frequency
assoc sx of ureteral pain
hematuria, nausea, and vomiting
Bladder/Vesical pain:
Severe suprapubic discomfort means
acute urinary retention*
Burning pain in the distal urethra with voiding:
acute cystitis
Constant suprapubic pain not related to the act of urination
usually NOT of urologic origin.
Bladder/Vesical pain is associated with
bladder distension
chronic distention - painless
Prostatic pain Assoc. Sx:
Dysuria, frequency and urgency
Flaccid penile pain
STI, paraphimosis
Erect penile pain
priapism and Peyronie’s disease
**Low-flow (ischemic)
failure of venous outflow
usually painful**
associated with sickle cell anemia, thalassemia, leukemia
**High flow (non-ischemic)
the result of uncontrolled arterial inflow from a fistula between the cavernosal artery and the corpus cavernosum
rupture of a cavernous artery from trauma
usually not painful**
Priapism for longer than 24 hours is associated with the likelihood of permanent
impotence.
Acute Testicular pain:
trauma, torsion, epididymitis, orchitis
location from within the scrotum to the ipsilateral groin
Chronic Testicular pain:
Varicocele, hydrocele
described as Heaviness” without radiation
Referred Testicular pain:
Disorders of the kidney, retroperitoneal structures, or inguinal canal
Irritative Voiding Symptoms
URGENCY
DYSURIA
FREQUENCY
NOCTURIA
Obstructive voiding Sxs
hesitancy
decreased force of stream
intermittency
post void dribbling
causes of obstructive voiding
BPH,
urethral stricture
neurogenic bladder disorders prostatic or urethral carcinoma
foreign body
Hematuria in adults is considered what kind of sign?
Malignancy
Bloody discharge:
Due to neoplasms, urethritis or trauma
Purulent discharge:
Thick and yellowish green
Due to gonococcal urethritis or chronic prostatitis
Types of incontinence
Overflow Functional Structural Urge Stress
Overflow
Bladder is always full so that it frequently leaks urine
Due to BPH, bladder tumor or stone, and peripheral neuropathy
Functional
Normal urine control but incontinence on the way to the toilet or only in the morning
**Unable to reach bathroom in time
Due to arthritis, weakness, Parkinson’s disease, Alzheimer’s disease, poor vision, and environmental factors
Structural
Congenital (ectopic ureter)
Acquired (prostatectomy)
Structural/ anatomic problem
Urge
Pass urine before reaching bathroom
Causes: stroke, brain tumor, dementia, spinal cord trauma
Mechanism: ↓ cortical inhibition of detrusor contractions
Stress
Urine leaks because of sudden pressure on the pelvic muscles
Occurs with weakened pelvic -childbirth (females) or surgery
Fever
If associated with UTI Sx: acute pyelonephritis, acute prostatitis, or acute epidydimitis
Weight loss and malaise:
cancer; chronic kidney disease
Balanitis and
Associated conditions:
Inflammation of glans penis
uncircumcised male, phimosis, infections, diabetes
Pearly penile papules
anatomical variant
profuse & yellow, thick discharge
Gonococcal urethritis
scanty & white or clear discharge
Non-gonoccocal urethritis, chlamydia
most common malformation of the urethral meatus
on the ventral surface of the penis
hypospadias
less common
on the dorsal surface of the penis
epispadia
hypospadias and epispadia are assoc w/
undescended testis,
UTI risk
infertility risk
the length of ≈ 4.5 cm.
Normal size
Small firm testes, ≤ 2 cm.
Klinefelter’s syndrome
Small soft testes
seen in cirrhosis,
myotonic dystrophy,
use of estrogens, hypopituitarism
Cryptorchidism increases the risk of
testicular cancer
(+) transillumination:
hydrocele, spermatocele
(-) transillumination:
testicular cancer,
hernia, varicocele
Congenital weakness of the internal inguinal ring
children (M/F) and young males
indirect inguinal hernia
Acquired weakness of the abdominal wall (Hesselbach triangle)
adults >40 ; M>F
direct inguinal hernia
Acquired weakness of the femoral canal.
F>M
femoral hernia
Enlarged, nodular, hard with loss of normal anatomic groove
Prostate Cancer:
Enlarged, smooth, firm with normal anatomic groove
Benign prostatic hyperplasia (BPH):
Soft, boggy and tender
Prostatitis:
