Male Genitourinary System

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Male Genitourinary System

• Chapter 24

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• Structure and Function
• Subjective DataHealth History Questions
• Objective DataThe Physical Exam
• Abnormal Findings

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Subjective DataHealth History Questions

• Frequency, urgency, and nocturia
• Dysuria
• Hesitancy and straining
• Urine color
• Genitourinary history

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Subjective DataHealth History Questions (cont.)

• Penispain, lesion, and/or discharge
• Scrotumself-care behaviors lump
• Sexual activity and contraceptive use
• Sexually transmitted disease contact

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Principles of interviewing adolescent male
patients

• Ask questions that seem appropriate for boys age
  but be aware that norms vary widely.
• Ask direct, matter-of-fact questions. Avoid
  sounding judgmental.
• Start with a permission statement. Often boys
  your age experience
• Try the ubiquity approach, When did you rather
  than Do you
• Sometimes all you do is open the door to later
  conversation

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Additional History for the Aging Adult

• Any difficulty urinating?...
• Do you need to get up at night
• A man in his 70s, 80s, or 90s

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Objective DataThe Physical Exam (cont.)

• PenisInspect and palpate
• Skin
• Glans
• Urethral meatus
• Pubic hair
• Urethral discharge
• Shaft

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Objective DataThe Physical Exam (cont.)

• ScrotumInspect and palpate
• Skin
• Testis
• Epididymis
• Spermatic cord
• Any mass
• Note characteristics
• Transillumination

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Abnormal FindingsMale Genital Lesions

• Herpes progenitalis
• Syphilitic chancre
• Condylomata acuminata (genital warts)
• Carcinoma
• Urethritis (urethral discharge and dysuria)

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Abnormal Findings (cont.)Abnormalities of the
Penis

• Phimosis
• Paraphimosis
• Hypospadias
• Epispadias
• Peyronies disease
• Priapism
• Urethral stricture

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Abnormal Findings (cont.)Abnormalities in the
Scrotum

• Early testicular tumor
• Diffuse tumor
• Hydrocele
• Scrotal hernia
• Orchitis
• Scrotal edema

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Abnormal Findings (cont.)Inguinal and Femoral
Hernias

• Indirect inguinal
• Direct inguinal
• Femoral