PART 2 MALE GENITALIA

Scrotal Hernia

A loop of bowel protrudes into the scrotum to create what is known as an indirect inguinal hernia.

Hernia appears as a swelling in the scrotum

Palpable as a soft mass and fingers cannot get above the mass.

Hydrocele

Collection of serous fluid in the scrotum, outside the testes, within the tunica vaginalis

Appears as swelling in the scrotum and is usually painless.

Usually, the examiner can get fingers above this mass during palpation

Will transilluminate (if there is blood in the scrotum, it will not transilluminate and is called a hematocele

Testicular Tumor

Initially a small, firm, nontender nodule on the testis

As the tumor grows, the scrotum appears enlarged and the client complains of a heavy feeling

When palpated, the testis feels enlarged and smooth-tumor replaces testis

Will not transilluminate

Cryptorchidism

Failure of one or both testicles to descend into scrotum

Scrotum appears undeveloped and testis cannot be palpated.

Causes increased risk of testicular cancer

Orchitis

Inflammation of the testes, associated frequently with mumps

Client complains of pain, heaviness, and fever

Scrotum appears enlarged and reddened

Swollen, tender testis is palpated. The examiner may have difficulty differentiating between testis and epididymis

Small Testes

Small ( <3.5 cm long), soft testes indicate atrophy. Atrophy may result from cirrhosis, hypopituitarism, estrogen administration, extended illness, or the disorder may occur after orchitis.

Small (<2 cm long), firm testes may indicate Klinefelter syndrome.

Epididymitis

Infection of the epididymis

Client usually complains of sudden pain

Scrotum appears enlarged, reddened, and swollen, tender epididymis is palpated

Usually associated with prostatitis or bacterial infection

Torsion of Spermatic Cord

Very painful condition caused by twisting of spermatic cord

Scrotum appears enlarged and reddened

Palpation reveals thickened cord and swollen, tender testis that may be higher in scrotum than normal.

This condition requires immediate referral for surgery because circulation is obstructed

Varicocele

Abnormal dilation of veins in the spermatic cord

The client may complain of discomfort and testicular heaviness

Tortuous veins are palpable and fell like a soft, irregular mass, or “ a bag of worms’ that collapses when the client is supine

Infertility may be associated with this condition.

Indirect Inguinal Hernia

Bowel herniates through the internal inguinal ring and remains in the inguinal canal or travels down into the scrotum (scrotal hernia)

This is the most common type of hernia

It may occur in adults, but is more frequent in children.

Femoral Hernia

Bowel herniates through the femoral ring and canal. It never travels into the scrotum, and the inguinal canal is empty.

This is the least common type of hernia

It occurs mostly in women,

Direst Inguinal Hernia

Bowel herniates from behind and through the external inguinal ring. It rarely travels down into the scrotum.

This type of hernia is less common than an indirect hernia

it occurs mostly in adult men older than age 40

External Hemorrhoid

Hemorrhoids are usually painless papules caused by varicose veins. They can be internal or external ( above or below the anorectal junction). This external hemorrhoid has become thrombosed- it contains clotted blood, is very painful and swollen, and itches and bleeds with bowel movements.

Perianal Abscess

Is a cavity of pus, caused by infection in the skin around the anal opening. It causes throbbing pain and is red, swollen, hard, and tender.

Pilonidal Cyst

This congenitinal disorder is characterized by a small dimple or cyst/sinus that contains hair. It is located midline in the sacrococcygeal area and has palpable sinus tract

Rectal Cancer

A rectal carcinoma is usually asymptomatic until it is quite advanced. Thus, routine rectal palpation is essential. A cancer of the rectum may feel like a firm nodule, an ulcerated nodule with rolled edges or as it arouse a large irregularly shaped, fixed, hard nodule.

Rectal Polyps

These soft structures are rather common and occur in varying sizes and numbers. There are two types: pendiculated ( on a stalk) and sessile ( on the mucosal surface)

Rectal Shelf

If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure that protrudes onto the anterior surface of the rectum in the area of the seminal vesicles in men and in the area of the rectouterine pouch in women.