Male Genitourinary System

Aging Adult NORMAL findings

• pubic hair decrease

• penis size decrease

• size of testes may be decreased and less firm to palpatation

• scrotal sac pendulous with less rugae

• less sperm produced around age 40

• testosterone declines after age 30

Why are circumcisions done?

to lower risk of certain STIs such as HPV, herpes simplex virus, and genital ulcer disease

Testicular Self- Examination

T- timing, once a month

S- shower, warm water relaxes scrotal sac

E- examine, check for, and report changes immediately

What happens during the scrotum transillumination evaluation?

A light is held behind the scrotum so that one can easily determine whether the mass is cystic (light shines through) or solid (light blocked by the mass)

Scientific word for absent testis

cryptorchdism

testicular torsion

testicle rotates on the spermatic cord, bringing blood to the testicle from the abdomen

epididymitis

inflammation of the coiled tube at the back of the testicle

varicocele

abnormal dilation and enlargement of the scrotal venous pampiniform plexus which drains blood from each testicle

spermatocele

abnormal sac that develops in the epididymis

early testicular tumor

a painless lump or swelling on either testicle

Diffuse tumor

tumor with bad defined boundaries

hydrocele

type of swelling in the scrotum- the pouch of skin holds the testicles

scrotal hernia

visible bulge

orchitis

inflammation of one or both testicles

scrotal edema

larger than usual testicles that may look shiny or red

indirect inguinal hernia

abdominal contents protrude through the internal inguinal ring and into the inguinal canal

direct inguinal hernia

Hernia penetrates directly through the wall of the inguinal canal. Occurs over-time from chronic pressure and weakening of abdominal muscles

femoral hernia

Protrusion of a loop of the intestine through a weakened abdominal wall- located in lower abdomen near thigh.

When are hernias life threatening?

If they become strangulated and there is no blood flow to the tissue

What is tested for in a urinary function test?

• color- certain colors can be correlated with etiology. meds, food, and supplements can change the color

• pH

• specific gravity

• creatinine/BUN for kidney function (dark urine means protein or dehydration)

What is an abnormal finding when palpating inguinal lymph nodes?

enlarged, hard, matted, and fixed to one area

What is a normal finding if someone’s foreskin is intact?

Cheesy smegma underneath the foreskin after getting pulled back

History questions for the aging adult

• difficulty urinating?

• do they leak urine?

• do they need to get up at night to urinate?

• sexual function issues?

urgency incontinence

sudden loss (ex. with acute cystitis)

stress incontinence

involuntary urine loss with physical strain, sneezing, or coughing due to weakness of pelvic floor

What could trouble starting a urine stream mean?

possible kidney stone

Why is there such a high transmission rate of STIs?

many are asymptomatic

common STIs

chlamydia, gonorrhea, syphilis, HPV, HIV, and Hep B

dysuria

pain with urination