MALE GENITALIA ABNORMALITIES

ABNORMALITIES OF THE PENIS

SYPHILITIC CHANCRE

• small, silvery-white papule that develops a red, oval ulceration

• Painless

• A sign of primary syphilis (an STI) that spontaneously regresses

• misdiagnosed as herpes

HERPES PROGENITALIS

• Clusters of pimple-like, clear vesicles erupt and become ulcers

• Painful

• Initial lesions of this STI—typically caused by HSV-1 or HSV-2—disappear, and recur, can be frequent or minimally episodic.

GENITAL WARTS

• Single or multiple, moist, fleshy papules

• Painless

• STI caused by the HPV

CANCER OF THE GLANS PENIS

• Appears as hardened nodule or ulcer on the glans

• Painless

• Occurs primarily in uncircumcised men

PHIMOSIS

the foreskin cannot be retracted over the penis tip

PARAPHIMOSIS

A foreskin that is left in a retracted position leads to venous congestion and edema of the foreskin

HYPOSPADIAS

• Urethral meatus is located underneath the glans (ventral side).

• congenital defect.

• A groove extends from the meatus to the normal location of the urethral meatus.

EPISPADIAS

• The urethral meatus is located on the top of the glans (dorsal side); occurs rarely.

• congenital defect.

ABNORMALITIES OF THE SCROTUM

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.

• 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 patient 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

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.

• circulation is obstructed.

VARICOCELE

• Abnormal dilation of veins in the spermatic cord

• Client may complain of discomfort and testicular heaviness.

• Tortuous veins are palpable and feel like a soft, “a bag of worms” that collapses when the client is supine.

• Infertility may be associated with this condition.

SPERMATOCELE

• Sperm-filled cystic mass located on epididymis

• Palpable as small and nontender, and movable above the testis

• This mass will appear on transillumination.

ABNORMALITIES OF ANUS AND RECTUM:

EXTERNAL HEMORRHOID

  • Hemorrhoids are usually painless papules caused by varicose veins.

  • They can be internal or external (above or below the anorectal junction).

PERIANAL ABSCESS

  • Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.

  • Throbbing pain and is red, swollen, hard, and tender.

ANAL FISSURE

  • splits in the tissue of the anal canal are caused by trauma.

  • A swollen skin tag (“sentinel tag”) is often present below the fissure on the anal margin.

  • intense pain, itching, and bleeding

ANORECTAL FISTULA

  • a small, round opening in the skin that surrounds the anal opening.

  • inflammatory tract from the anus or rectum out to the skin. A previous abscess may have preceded the fistula

RECTAL PROLAPSE

  • This occurs when the mucosa of the rectum protrudes out through the anal opening. It may involve only the mucosa or the mucosa and the rectal wall.

  • It appears as a red, doughnutlike mass with radiating folds

PILONIDAL CYST

  • Congenital disorder

  • Characterized by a small dimple or cyst/sinus that contains hair

  • Located midline in the sacrococcygeal area and has a palpable sinus tract

RECTAL POLYPS

  • Soft structures are rather common and occur in varying sizes and numbers

  • Two types: pedunculated (on a stalk) and sessile (on the mucosal surface)

RECTAL CANCER

  • Usually asymptomatic until it is quite advanced, (routine rectal palpation is essential)

  • Feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule

RECTAL SHELF

  • If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelflike 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

ABNORMALITIES IN THE PROSTATE GLAND:

ACUTE PROSTATITIS

  • Prostate is swollen, tender, firm, and warm to the touch.

  • Caused by a bacterial infection

BENIGN PROSTATIC HYPERTROPHY

  • Prostate is enlarged, smooth, firm, and slightly elastic

  • The median sulcus may not be palpable

  • Common in men older than 50 years

CANCER OF THE PROSTATE

  • Hard area on the prostate or hard, fixed, irregular nodules on the prostate suggest cancer

  • The median sulcus may not be palpable