GU/GI PT2

What happens to testosterone levels with age?

Gradually decrease after age 30–40, causing slower sexual response and reduced firmness of erections.

How does aging affect the penis and scrotum?

Penis size decreases; scrotal contents hang lower, rugae decrease, and scrotum becomes pendulous.

What urinary changes may occur in aging men?

Increased frequency, urgency, nocturia, and risk of benign prostatic hyperplasia (BPH) leading to hesitancy or dribbling.

What is a common prostate change in older men?

Prostate gland enlarges (BPH), which may compress the urethra and cause obstructive urinary symptoms.

How does rectal tone change with age?

Decreased sphincter tone and rectal sensation, increasing risk for incontinence.

How does prostate texture change with aging?

The prostate may feel larger, smooth, and firm (BPH); or irregular and hard (suggestive of malignancy).

What are older adults at increased risk for regarding colorectal health?

Higher risk for colorectal cancer; screening becomes increasingly important.

What happens to estrogen levels after menopause?

Sharp decrease, causing vaginal atrophy, dryness, and thinning of mucosa.

How is the uterus affected postmenopause?

Uterus shrinks and may drop forward; ovaries also atrophy and are non-palpable.

What are common symptoms of vaginal aging?

Dryness, itching, burning, and increased risk of irritation and infection (e.g., atrophic vaginitis).

What urinary symptoms are common in aging women?

Increased risk for stress incontinence due to weakened pelvic muscles and urethral structures.

How does the cervix change postmenopause?

Becomes smaller, pale, and may appear flush with vaginal wall.

What is cryptorchidism?

Undescended testes—common in premature infants; increases risk of infertility and testicular cancer.

What is epididymitis?

Severe pain of sudden onset in scrotum; inflamed epididymis often caused by bacterial infection or STIs.

What is testicular torsion?

Twisting of spermatic cord—sudden scrotal pain, swelling, and high-riding testis; medical emergency.

What is varicocele?

Dilated, tortuous varicose veins in the spermatic cord; may feel like a 'bag of worms'.

What is paraphimosis?

Foreskin is retracted and cannot be returned, leading to constriction and edema—urgent.

What are signs of an anorectal fistula?

Red, raised opening near the anus; may drain purulent fluid and be painful.

What is a thrombosed hemorrhoid?

Swollen, blue, shiny, painful perianal lump; blood clot within an external hemorrhoid.

What are characteristics of an enlarged prostate?

Symmetrically enlarged, smooth, firm without a median sulcus—suggests BPH.

What indicates possible prostate cancer during a rectal exam?

Stone-hard, irregular, fixed nodule on posterior surface of the prostate.

What is fecal impaction?

Hard stool in the rectum that blocks passage of normal stool; may lead to overflow incontinence.

What is candidiasis?

Thick, white, curd-like vaginal discharge with intense pruritus; common after antibiotic use.

What is bacterial vaginosis?

Thin, gray-white discharge with fishy odor; clue cells seen on wet mount.

What are signs of trichomoniasis?

Frothy, yellow-green discharge, pruritus, and strawberry cervix.

What is uterine prolapse?

Uterus protrudes into the vaginal canal; graded by degree of descent.

What are genital warts (HPV)?

Painless, flesh-colored, cauliflower-like lesions caused by HPV.

What changes occur in sperm production with age?

Sperm production decreases around age 40 but continues into old age, although fertility is reduced.

What effect does aging have on nocturia in men?

More common due to decreased bladder capacity and increased urine production at night.

How does aging affect the testes?

Testes decrease in size and are less firm to palpation.

What common complaint may older adults report related to bowel movements?

Constipation due to decreased motility, less physical activity, lower fluid/fiber intake, and medications.

What is the clinical relevance of a median sulcus in the prostate exam?

A palpable median sulcus is normal; obliteration may suggest BPH or prostate cancer.

What is a concern for rectal bleeding in older adults?

Always investigate for malignancy or gastrointestinal disease; it's not considered 'normal aging.'

What happens to the mons pubis and labia with age?

Fat decreases in mons pubis; labia majora and minora become smaller and flatter.

How does aging affect the vaginal pH?

pH becomes more alkaline due to decreased glycogen, increasing risk for infections.

What changes occur in the pelvic floor in older women?

Weakened pelvic floor muscles can lead to uterine or bladder prolapse, incontinence, or pelvic organ dysfunction.

What breast or genitourinary symptom may postmenopausal women report?

Dyspareunia (painful intercourse) due to vaginal dryness and thinning epithelium.