Chapter 26 - M. Genitalia

What are some things to ask when collecting subjective data about male genitalia?

• pain? itching?

• lesions/discharge?

• lumps/swelling/masses?

• burning/pain w/ urination?

• urine changes?

• changes in libido? ED?

• family hx of cancer?

• multiple sexual partners?

• prior GU, rectal, prostate or STI hx?

What may a heavy scrotum feeling indicate?

Possible hernia or testicular tumor

What are some prostate cancer risk factors?

• age > 50

• family hx

• environmental exposures (chemicals, agent orange)

• high fat/red meat, low veggie diet

• alcohol use

What are ways to reduce the risk of prostate cancer?

• screenings b/w age 55-69

• DRE test

• PSA blood test

• healthy diet, limit alcohol

• regular exercise, healthy weight

• adequate sleep

What are late-stage protaste cancer symptoms?

• trouble urinating

• weak urine stream

• blood in semen

• pelvic discomfort

• bone pain

• ED

What areas can you inspect/palpate during the male genitalia physical exam?

penis, scrotum, inguinal area, anal area

How do you inspect/palpate for urethral discharge?

Squeeze glans b/w thumb and index finger

What color urethral discharge is associated w/ gonorrhea

yellow

What color urethral discharge is associated w/ uretheritis

clear or white

When inspecting the anal area, what positions can the pt be in?

standing or left lateral

What are 3 ways to assess the scrotum?

Inspection, auscultation, transillumination

What is transilluminate? How is it useful in the male genitalia physical exam?

Means to pass bright light through a body part to examine what lies beneathe it; useful when inspecting the scrotum

How often should a testicular self-examination (TSE) be performed?

Once a month

When is the most convenient time to do a TSE?

After a warm bath or shower when scrotum is relaxed

How do you perform a TSE?

With index and middle finger under testis and thumb on top, roll the testis gently in a horizontal plane b/w thumb and fingers

Is one testis being larger than the other normal?

Yes - unless it’s is significant or you feel lumps/masses

What are nonmodificable colorectal cancer risk factors?

• older age

• ethnicity

• IBS (crohn’s ulcerative colitis)

• personal, family hx

• genetic syndromes (FAP, lynch)

• type ii DM

What are modificable colorectal cancer risk factors?

• obesity

• physical inactivity

• diet high in red/processed meat

• diet low in fruits, veggies, whole grains

• smoking

• alcohol

• HPV

How does colorectal cancer usually start?

polyps in the colon or rectum

What are some ways to screen for colorectal cancer?

screen starting at age 45-50 thru 75

• colonoscopy

• sigmoidoscopy

• stool blood/FIT tests

What are some ways to prevent colorectal cancer?

• eat more fiber, fruits, veggies, whole grains

• limit red/processed meat, smoking, alc

What is important pt education regarding colorectal cancer?

• report black tarry stools, changes in bowel habits, and unexplained weight loss

• follow screening schedule

What are some older adult considerations regarding male genitalia?

• pubic hair may be gray, sparse

• penis may look smaller

• scrotum may hang/droop

• scrotal skin may have less rugae

• testes may be smaller and softer