PHYSICAL EXAMINATION OF THE MALE GENITALIA Flashcards
HPI considerations
Difficulty achieving or maintaining erection.
Ask patients about
- pain with erection,
- pattern of erection with one or more partners,
- alcohol and medication ingestion,
- erections unrelated to sexual stimulation,
- curvature of erect penis.
HPI considerations
Difficulty with ejaculation
Pertinent data include:
- painful or premature ejaculation
- color and consistency of fluids,
- medications used on a regular basis.
HPI considerations
Discharge or lesions on the penis.
Note the…
- character of lesion (lumps, sores, rashes)
- discharge (color, consistency, odor).
- Record any associated symptoms (e.g., itching or burning),
- exposure to sexually transmitted infections,
- medications used.
HPI considerations
Infertility.
Patients reporting problems with conceiving should be assessed for
- lifestyle factors (e.g., hot tub use),
- length of time attempting pregnancy,
- knowledge of fertile period of woman’s reproductive cycle,
- incidence of undescended testes,
- previous diagnostic studies (e.g., semen analysis or sperm antibody titers)
- medications used.
HPI considerations
Enlargement in inguinal area.
Questions relevant to:
- enlarged inguinal area address pain associated with lifting,
- change in size or character of mass,
- groin pain,
- use of truss or other treatment,
- medications used.
HPI considerations
Testicular pain or mass.
Patients should be assessed for:
- changes in testicular size,
- events surrounding onset (e.g., sporting event),
- any irregular lumps,
- soreness,
- heaviness of testes,
- medications used.
Past Medical History considerations
Pertinent data include:
- previous genitourinary tract surgeries (e.g., surgery to correct hypospadias or hernia),
- sexually transmitted infections
- chronic illnesses (e.g., prostatic cancer, arthritis, or neurologic or -vascular impairment).
Family History Considerations
Data should be collected on:
- any infertility problems in siblings,
- hernias in family members,
- family history of prostate, testicular, or penile cancer.
Personal and Social History
Relevant data include
- employment risks (e.g., exposure to toxins),
- exercise patterns,
- concerns about genitalia,
- testicular self-examination practices,
- concerns about sexual practices,
- reproductive function (number of children, form of contraceptive use),
- use of medications, alcohol, or street drugs that may interfere with sexual response.
HPI considerations in older adults
Relevant data include:
- sexual activity patterns
- any changes in sexual response or desire.
HPI considerations in Adolescents.
Relevant data include knowledge of:
- reproductive function,
- presence of nocturnal emissions,
- enlargement of genitalia,
- sexual activity patterns,
- use of contraceptives,
- concerns of sexual abuse.
HPI considerations for Infants and children
-Information should be gathered on maternal use of sex hormones or birth control pills during pregnancy.
-Circumcised infants should be assessed for any complication from the procedure.
-Pertinent data for uncircumcised infants include hygiene measures and retractability of foreskin.
-Congenital anomalies (e.g., epispadias) and any incidence of scrotal swelling when infant is crying or having bowel movements
should be recorded.
-Notation should also be made of any swelling, discoloration, sores on penis or scrotum, and genital pain.
-Questions should be asked about any concerns with masturbation, sexual exploration, or sexual abuse.
Erection of the penis occurs when the two corpora cavernosa become engorged with _______ mL of blood in response to the autonomic nervous system.
20 to 50 mL
True/False
Examination
Patient may be lying or standing.
Examination of the genitalia involves…
- inspection,
- palpation, and
- transillumination of any mass found.
