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Advanced Health Assessment

Advanced Health Assessment. July 27, 1999. ASSESSMENT OF MALE GENITALIA. Jay Gilbaugh, M. D. 851 N. Hillside, Wichita 316-685-1371. Anatomic Review. Penis Scrotum Inguinal Canal Testes. Anatomic Review. Epididymis Spermatic Cord Prostate Seminal Vesicles. Genitourinary History.

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Advanced Health Assessment

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  1. Advanced Health Assessment • July 27, 1999

  2. ASSESSMENT OF MALE GENITALIA Jay Gilbaugh, M. D. 851 N. Hillside, Wichita 316-685-1371

  3. Anatomic Review • Penis • Scrotum • Inguinal Canal • Testes

  4. Anatomic Review • Epididymis • Spermatic Cord • Prostate • Seminal Vesicles

  5. Genitourinary History • Previous surgeries, conditions • Previous UTI or STD • Testicular pain or mass • Penile lesion or discharge • Voiding history

  6. Voiding History • Quality or urine stream • Nocturia - quantitate • Urinary frequency • Hesitancy, urgency, double voiding, post-void dribbling or feeling of incomplete emptying

  7. Voiding History • Dysuria • Hematuria • Incontinence • Stress • Urge

  8. Sexual History • Quality of libido • Quality of erections • Problems with ejaculation

  9. Physical Exam • General • Penis • Common abnormalities • Scrotum • Scrotal contents • Groin • Prostate

  10. General Exam • Inspection, palpation, transillumination • Patient standing (easiest) • Professional, straight-forward • Minimize patient anxiety

  11. Exam of Penis • Inspect shaft for gross lesions • Palpate shaft for plaques • Retract foreskin (except infants) • Examine glans for gross lesions

  12. Exam of Penis • Examine meatus for size & location • Evert meatus to inspect fossa navicularis • Examine for urethral discharge • Reduce foreskin after exam!

  13. Common Abnormalities: Shaft • Peyronie’s disease • Skin lesions • herpes • condylomata accuminatum (venereal warts) • molluscum contagiosum • Priapism - persistent, prolonged erection

  14. Common Abnormalities: Prepuce • Phimosis • Paraphimosis

  15. Common Abnormalities: Glans • Balanitis/balanoposthitis • Pearly papules • Chancre/ulcer

  16. Common Abnormalities: Meatus • Stenosis • Position • Epispadias • Hypospadias

  17. Exam of Scrotum • Inspect for gross lesions • Palpate for thickness • Palpate inguinal canals

  18. Common Abnormalities: Scrotum • Sebaceous cysts of scrotum • Scrotal edema • Scrotal erythema • Yeast infection • Fournier’s ganrene (necrotizing fasciitis) • Inguinal hernias

  19. Exam: Scrotal Contents • Palpate testis for consistency & masses • Palpate epididymis for consistency, tenderness, masses • Palpate vas deferens for presence • Palpate spermatic cord for varicosities (valsalva) • Check cremasteric reflex

  20. Common Abnormalities: Testes • Hydrocele - transilluminate • Testicular cancer • Testicular torsion

  21. Common Abnormalities: Epididymis • Epididymitis • Spermatocele (epididymal cyst)

  22. Common Abnormalities: Spermatic Cord • Varicocele

  23. Exam of Groin • Palpate for inguinal adenopathy

  24. Exam of Prostate • Use plenty of water-soluble lubricant • Have patient bear down, as with having BM • Palpate both sides to compare: • Size • Consistency • Tenderness

  25. Common Abnormalities • Prostatic hypertrophy • Prostatitis syndromes • Prostate Cancer

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