PI

Question 1

 Pain with erection, prolonged painful erection
 Constant or intermittent, with one or more sexual partners
 Associated with alcohol, medication
 Meds: diuretics, sedatives, antihypertensive agents, anxiolytics, estrogens, inhibitors of androgen synthesis, antidepressants, cabamazepine, erectile dysfunction agents

Answer 1

Difficulty achieving or maintaining an erection

Question 2

 Current history of sickle cell anemia, leukemia, multiple sclerosis, diabetes, spinal cord injury
 Trauma to genitals or groin
 Associated with alcohol, medication
 Meds: ED agents, antidepressants, antipsychotics, anticoagulants, anxiolytics, recreational drugs

Answer 2

Persistent erections unrelated to sexual stimulation

Question 3

 Associated pain
 Injury to penis
 Personal Hx: diabetes, contracture of 4th and 5th fingers (Dupuytren contracture)
 Family history of condition
 Medications: propanolol (HTN, angina , irregular heartbeat, migraine headaches, tremors) (beta blocker

Answer 3

Curvature of penis in any direction with erection

Question 4

 Painful? Premature?
 Efforts to treat the problem
 Ejaculate color, consistency, odor, amount
 Meds: alpha blockers, antidepressants, antipsychotics, clonidine, methyldopa

Answer 4

Difficulty with ejaculation

Question 5

 Character: lumps, sores, rash
 Discharge: color, consistency, odor, tendency to stain underwear
 Symptoms: itching, burning, stinging
 Exposure to STI: multiple partners, infection in partners, failure to use condom, Hx prior STI

Answer 5

Discharge or lesion on the penis

Question 6

 Lifestyle factors that may increase temperature of the scrotum
◦ Tight clothing, briefs, hot baths, employment in high-temperature environment or requiring prolonged sitting (truck driving), varicocele
 Length of time attempting pregnancy, sexual activity pattern, knowledge of fertile period of woman’s reproductive cycle
 History of undescended testes
 Diagnostic evaluation to date: semen analysis, physical examination, sperm antibody titers
 Meds: testosterone, glucocorticoids, hypothalamic releasing hormone

Answer 6

Infertility

Question 7

 Intermittent/constant, associated with straining/lifting, duration, pain?
 Change in size or character of mass;
 Ability to reduce the mass
◦ If unable to, how long since it could be reduced?
 Groin pain: character (tearing, sudden, searing, cutting) associated activity (lifting heavy object, coughing, straining at stool)
 Use of truss or other Tx
 Meds: analgesics

Answer 7

Enlargement in inguinal area

Question 8

 Change in testicular size
 Events surrounding onset: noted casually while bathing, after trauma, during a sporting event
 Irregular lumps, soreness, or heaviness of testes
 Meds: analgesics, antibiotics

Answer 8

Testicular pain or mass