Term
| Lack of libido may arise from |
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Definition
| psychogenic causes such as depression, endocrine dysfunction, or side effects of medications |
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Term
| Erectile dysfunction may be from |
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Definition
psychogenic causes, especially if early morning erection is preserved;
also from decreased testosterone, decreased blood flow in the hypogastric arterial system, or impaired neural innervation |
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Term
reduced or absent ejaculation affecting middle-aged or older men. Possible causes are?
Lack of orgasm with ejaculation is usually psychogenic. |
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Definition
| medications, surgery, neurologic deficits, or lack of androgen. |
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Term
| Penile discharge may accompany |
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Definition
| gonococcal (usually yellow) and nongonococcal urethritis (may be clear or white). |
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Term
| Infections from oral-penile transmission include |
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Definition
gonorrhea, chlamydia, syphilis, and herpes.
(Symptomatic or asymptomatic proctitis may follow anal intercourse) |
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Term
1-Phimosis is
2-Paraphimosis is |
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Definition
1-Phimosis is a tight prepuce that cannot be retracted over the glans.
2-Paraphimosis is a tight prepuce that, once retracted, cannot be returned. Edema ensues. |
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Term
1-Balanitis
2-balanoposthitis |
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Definition
1-Balanitis (inflammation of the glans);
2-balanoposthitis (inflammation of the glans and prepuce) |
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Term
| Pubic or genital excoriations suggest the possibility of |
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Definition
| lice (crabs) or sometimes scabies |
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Term
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Definition
| a congenital, ventral displacement of the meatus on the penis |
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Term
1-Profuse yellow discharge in
2-scanty white or clear discharge in |
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Definition
1-Profuse yellow discharge in gonococcal urethritis;
2-scanty white or clear discharge in nongonococcal urethritis.
(Definitive diagnosis requires Gram stain and culture) |
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Term
Induration along the ventral surface of the penis suggests
Tenderness of such an indurated area suggests |
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Definition
Induration along the ventral surface of the penis suggests a urethral stricture or possibly a carcinoma.
Tenderness of such an indurated area suggests periurethral inflammation secondary to a urethral stricture |
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Term
| There may be dome-shaped white or yellow papules or nodules formed by occluded follicles filled with keratin debris of desquamated follicular epithelium. Such epidermoid cysts are common, frequently multiple, and benign |
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Definition
|
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Term
| A poorly developed scrotum on one or both sides suggests |
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Definition
| cryptorchidism (an undescended testicle). |
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Term
| Common scrotal swellings include |
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Definition
| indirect inguinal hernias, hydroceles, and scrotal edema |
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Term
Tender, painful scrotal swelling in |
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Definition
| acute epididymitis, acute orchitis, torsion of the spermatic cord, or a strangulated inguinal hernia. |
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Term
Any painless nodule in the testis must raise the possibility of |
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Definition
| testicular cancer, a potentially curable cancer with a peak incidence between the ages of 15 and 35 years. |
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Term
| Multiple tortuous veins in this area, usually on the left, may be palpable and even visible. They indicate a |
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Definition
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Term
The vas deferens, if chronically infected, may feel thickened or beaded. A cystic structure in the spermatic cord suggests |
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Definition
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Term
Swellings containing serous fluid, as in hydroceles, light up with a red glow, or transilluminate. Those containing blood or tissue, such as a normal testis, a tumor, or most hernias, do not. |
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Definition
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Term
| A bulge that appears on straining suggests |
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Definition
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Term
1-A bulge near the external inguinal ring suggests
2-A bulge near the internal inguinal ring suggests |
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Definition
1-A bulge near the external inguinal ring suggests a direct inguinal hernia.
2-A bulge near the internal inguinal ring suggests an indirect inguinal hernia. |
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Term
1-If you find a large scrotal mass and suspect that it may be a hernia, ask the patient to lie down. The mass may return to the abdomen by itself. If so, __________
2-Can you get your fingers above the mass in the scrotum?
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Definition
1-If you find a large scrotal mass and suspect that it may be a hernia, ask the patient to lie down. The mass may return to the abdomen by itself. If so, it is a hernia. If not:
• Can you get your fingers above the mass in the scrotum?
• Listen to the mass with a stethoscope for bowel sounds.
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Term
1-A hernia is incarcerated when
2-A hernia is strangulated when |
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Definition
A hernia is incarcerated when its contents cannot be returned to the abdominal cavity.
A hernia is strangulated when the blood supply to the entrapped contents is compromised. Suspect strangulation in the presence of tenderness, nausea, and vomiting and consider surgical intervention |
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Term
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Definition
| A congenital displacement of the urethral meatus to the inferior surface of the penis. A groove extends from the actual urethral meatus to its normal location on the tip of the glans. |
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Term
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Definition
| Pitting edema may make the scrotal skin taut; seen in congestive heart failure or nephrotic syndrome. |
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Term
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Definition
| Palpable, nontender, hard plaques are found just beneath the skin, usually along the dorsum of the penis. The patient complains of crooked, painful erections |
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Term
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Definition
| A nontender, fluid-filled mass within the tunica vaginalis. It transilluminates, and the examining fingers can get above the mass within the scrotum. |
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Term
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Definition
| An indurated nodule or ulcer that is usually nontender. Limited almost completely to men who are not circumcised, it may be masked by the prepuce. Any persistent penile sore is suspicious |
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Term
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Definition
| Usually an indirect inguinal hernia, that comes through the external inguinal ring, so the examining fingers cannot get above it within the scrotum. |
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Term
| Genital Warts (condylomata acuminata) |
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Definition
-
Appearance: Single or multiple papules or plaques of variable shapes; may be round, acuminate (or pointed), or thin and slender. May be raised, flat, or cauliflower-like (verrucous).
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Causative organism: Human papillomavirus (HPV), usually from subtypes 6, 11; carcinogenic subtypes rare, approximately 5-10% of all anogenital warts. Incubation: weeks to months; infected contact may have no visible warts.
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Can arise on penis, scrotum, groin, thighs, anus; usually asymptomatic, occasionally cause itching and pain.
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May disappear without treatment.
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Term
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Definition
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Appearance: Small scattered or grouped vesicles, 1-3 mm in size, on glans or shaft of penis. Appear as erosions if vesicular membrane breaks.
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Causative organism: Usually Herpes simplex virus 2 (90%), a double-stranded DNA virus. Incubation: 2 to 7 days after exposure.
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Primary episode may be asymptomatic; recurrence usually less painful, of shorter duration.
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Associated with fever, malaise, headache, arthralgias; local pain and edema, lymphadenopathy.
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Need to distinguish from genital herpes zoster (usually in older patients with dermatomal distribution); candidiasis.
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Term
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Definition
-
Appearance: Small red papule that becomes a chancre, or painless erosion up to 2 cm in diameter. Base of chancre is clean, red, smooth, and glistening; borders are raised and indurated. Chancre heals within 3-8 weeks.
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Causative organism: Treponema pallidum, a spirochete. Incubation: 9 to 90 days after exposure.
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May develop inguinal lymphadenopathy within 7 days; lymph nodes are rubbery, nontender, mobile.
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20%-30% of patients develop secondary syphilis while chancre still present (suggests co-infection with HIV).
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Distinguish from: genital herpes simplex; chancroid; granuloma inguinale from Klebsiella granulomatis (rare in U.S.; 4 variants, so difficult to identify).
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Term
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Definition
-
Appearance: Red papule or pustule initially, then forms a painful deep ulcer with ragged non-indurated margins; contains necrotic exudate, has a friable base.
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Causative organism: Haemophilus ducreyi, an anaerobic bacillus. Incubation: 3 to 7 days after exposure.
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Painful inguinal adenopathy; suppurative boboes in 25% of patients.
-
Need to distinguish from: primary syphilis; genital herpes simplex; lymphomogranuloma venerium, granuloma inguinale from Klebsiella granulomatis (both rare in U.S.).
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Term
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Definition
| The testis is atrophied and may lie in the inguinal canal or the abdomen, resulting in an unfilled scrotum. As above, there is no palpable left testis or epididymis. Cryptorchidism markedly raises the risk for testicular cancer. |
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Term
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Definition
| In adults, testicular length is usually ≤3.5 cm. Small, firm testes in Klinefelter's syndrome, usually ≤2 cm. Small, soft testes suggesting atrophy are seen in cirrhosis, myotonic dystrophy, use of estrogens, and hypopituitarism; may also follow orchitis. |
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Term
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Definition
| The testis is acutely inflamed, painful, tender, and swollen. It may be difficult to distinguish from the epididymis. The scrotum may be reddened. Seen in mumps and other viral infections; usually unilateral. |
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Term
Tumor of the Testis
early stage
late stage |
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Definition
early-Usually appears as a painless nodule. Any nodule within the testis warrants investigation for malignancy.
Late-As a testicular neoplasm grows and spreads, it may seem to replace the entire organ. The testicle characteristically feels heavier than normal. |
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Term
| Spermatocele and Cyst of the Epididymis |
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Definition
| A painless, movable cystic mass just above the testis suggests a spermatocele or an epididymal cyst. Both transilluminate. The former contains sperm, and the latter does not, but they are clinically indistinguishable. |
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Term
| Varicocele of the Spermatic Cord |
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Definition
| Varicocele refers to varicose veins of the spermatic cord, usually found on the left. It feels like a soft “bag of worms” separate from the testis, and slowly collapses when the scrotum is elevated in the supine patient. Infertility may be associated. |
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Term
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Definition
| An acutely inflamed epididymis is tender and swollen and may be difficult to distinguish from the testis. The scrotum may be reddened and the vas deferens inflamed. It occurs chiefly in adults. Coexisting urinary tract infection or prostatitis supports the diagnosis. |
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Term
| Torsion of the Spermatic Cord |
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Definition
| Torsion, or twisting, of the testicle on its spermatic cord produces an acutely painful, tender, and swollen organ that is retracted upward in the scrotum. The scrotum becomes red and edematous. There is no associated urinary infection. Torsion, most common in adolescents, is a surgical emergency because of obstructed circulation. |
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Term
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Definition
| The chronic inflammation of tuberculosis produces a firm enlargement of the epididymis, which is sometimes tender, with thickening or beading of the vas deferens. |
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Term
Indirect Inguinal Hernias
Frequency, Age, and Sex
Point of Origin
Course
(Examining finger in inguinal canal during straining) |
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Definition
Frequency, Age, and Sex-Most common, all ages, both sexes. Often in children; may be in adults
Point of Origin-Above inguinal ligament, near its midpoint (the internal inguinal ring)
Course-Often into the scrotum
(Examining finger in inguinal canal during straining)-The hernia comes down the inguinal canal and touches the fingertip.
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Term
Direct Inguinal Hernias
Frequency, Age, and Sex
Point of Origin
Course
(Examining finger in inguinal canal during straining)
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Definition
Frequency, Age, and Sex-Less common. Usually in men older than 40; rare in womenPoint of Origin-Above inguinal ligament, close to the pubic tubercle (near the external inguinal ring)Course-Rarely into the scrotum
(Examining finger in inguinal canal during straining)-The hernia bulges anteriorly and pushes the side of the finger forward
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Term
Femoral Hernias
Frequency, Age, and Sex
Point of Origin
Course
(Examining finger in inguinal canal during straining)
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Definition
Frequency, Age, and Sex-Least common. More common in women than in men
Point of Origin-Below the inguinal ligament; appears more lateral than an inguinal hernia. Can be hard to differentiate from lymph nodes
Course-Never into the scrotum
(Examining finger in inguinal canal during straining)-The inguinal canal is empty.
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