Male Pelvic Disease Flashcards
Indirect inguinal hernia
Goes through deep and superficial inguinal rings
Direct inguinal hernia
May exit superficial inguinal ring, but doesn’t enter inguinal canal
Incarcerated hernia
Tissue that has extruded and cannot return to NML position w/o surgery
Strangulated hernia
Hernia with blood supply cut off
Paraphimosis
The inability to replace the foreskin to its usual position after it has been retracted behind the glans > can lead to constriction > gangrene of glans penis
Hypospadias
EUO is located on the ventral surface of the glans penis shaft or at the base of the penis
Epispadias
EUO located on dorsal surface of shaft
Syphilitic chancre
PAINLESS skin lesion associated with syphilis
Herpes
PAINFUL STI caused by HSV
Condyloma acuminata
PAINLESS genital warts caused by HPV
Lymphogranuloma venereum
PAINLESS lesion caused by chlamydia
-present with fever and malaise
Molluscum contagiosum
PAINLESS, benign skin infection caused by a poxvirus > umbilicated, smooth lesions
Peyronie’s disease
Fibrous band in corpus cavernosum in tunica albuginea > interferes with expansion during erection
Penile CA
PAINLESS ulceration that fails to heal
Hydrocele
- collection of peritoneal fluid between the parietal and visceral layers of the tunica vaginalis
- typically insidious onset of painless, transilluminating scrotal mass
- no tx unless symptomatic or communicating
Communicating hydrocele
- patent processus vaginalis
- Found in infancy
- Disappear in recumbent position
- Concomitant indirect hernia
- Should be surgically corrected
Spermatocele and Epididymal cyst
- Spermatocele = >2 cm
- Epididymal cyst = <2 cm
- benign fluid cystic masses
- painless, asymptomatic, intra-scrotal mass typically found on testicular self-exam or routine visit
- ultrasound should be done to be 100% sure
- no tx typical
Varicocele
- dilation of pampiniform plexus vv.
- standing, valsalva make more prominent
- bag of worms
- No tx if asymptomatic or incidentally found
- surgery if: infertile with abnormal semen parameters, pain, or testicular atrophy
acute epididymitis
- SEVERE swelling and EXCRUCIATING pain of epididymis and surrounding structures
- Fever, rigors, dysuria, urinary frequency/urgency
- (+) Prehn’s sign (better with scrotal elevation)
- Palpation reveals induration and swelling of the epididymis with exquisite tenderness
- tx = IV fluids and antibiotics OR NSAIDs, ice, oral antibiotics at home
Chronic epididymitis
- Typically an ‘otherwise healthy’ male presenting with scrotal pain
- If ‘noninfectious’ may have hx of heavy physical exertion, bicycle or motorcycle riding, trauma
- epididymal tenderness and induration to lesser degree than acute
- Infectious tx: oral antibiotics + NSAIDs, ice, scrotal elevation
- Noninfectious tx: elevation, rest, warm baths, NSAIDs
Orchitis
- typically co-exist with epididymitis
- tender, enlarged, indurated testicle
- if viral (mumps) treat symptoms
Testicular torsion
- Twisting of the spermatic cord that is allowed due to inadequate fixation of the testis to the tunica vaginalis
- young presentation with sudden, severe onset of pain with N/V (not sick with fever, etc. JUST PAINFUL)
- asymmetric, high-riding testes
- profound testicular swelling
- absent cremasteric reflex, absent Prehn’s
- tx with manual detorsion
