Male Genitalia and Hernias

Question 1

Indirect inguinal hernias

Answer 1

Develop at the internal inguinal ring, where the spermatic cord exits the abdomen; presents with a bulge near the external inguinal ring

Question 2

Direct inguinal hernias

Answer 2

Arise more medially from weakness in the floor of the inguinal canal; associated with straining and heavy lifting; presents with a bulge near the internal inguinal ring

Question 3

Femoral hernias

Answer 3

More likely to present as emergencies with bowel incarceration or strangulation

Question 4

What causes a lack of libido?

Answer 4

May arise from psychogenic causes such as depression, endocrine dysfunction, or side effects of medications

Question 5

What causes erectile dysfunction?

Answer 5

May be from psychogenic causes, especially if early morning erection if preserved; it may also reflect decreased testosterone, decreased blood flow in the hypogastric arterial system, impaired neural innervation, and diabetes

Question 6

What is premature ejaculation?

Answer 6

More commonly seen in young men than older men; possible causes are medications, surgery, neurologic deficits, or lack of androgen.

Question 7

What is reduced or absent ejaculation?

Answer 7

More commonly seen in older men; possible causes are medications, surgery, neurologic deficits, or lack of androgen.

Question 8

What is the primary cause of lack of orgasm?

Answer 8

Psychogenic problems

Question 9

What is a common symptom of gonorrhea?

Answer 9

Yellow penile discharge

Question 10

What is a common symptom of non-gonococcal urethritis from Chlamydia?

Answer 10

White penile discharge

Question 11

What are the symptoms of disseminated gonorrhea ?

Answer 11

rash, tenosynvitis, nonoarticular arthritis, and even meningitis

Question 12

Sores and growths on penis

Answer 12

look for ulcers in syphilitic chancre and herpes; warts for HPV; swelling in mumps orchitis, scrotal edema & testicular cancer; pain in testicular torsion, epididymitis & orchitis

Question 13

What can infections from oral-penile transmissions include?

Answer 13

Gonorrhea, chlamydia, syphilis & herpes

Question 14

What can occur after anal intercourse?

Answer 14

symptomatic or asymptomatic proctitis.

Question 15

Phimosis

Answer 15

A tight prepuce that cannot be retracted over the glans

Question 16

Paraphimosis

Answer 16

A tight prepuce that, once retracted, cannot be returned; edema occurs

Question 17

Balantitis

Answer 17

Inflammation of the glans

Question 18

Balanoposthitis

Answer 18

Inflammation of the glands and prepuce

Question 19

What can pubic or genital excoriations suggest?

Answer 19

Lice (crabs) or sometimes scabies

Question 20

Hypospadias

Answer 20

Congenital, ventral displacement of the meatus on the penis

Question 21

What occurs in gonococcal urethritis?

Answer 21

profuse yellow discharge; definitive diagnosis requires Gram stain and culture

Question 22

What occurs in nongonococcal urethritis?

Answer 22

scanty white or clear discharge; definitive diagnosis requires Gram stain and culture

Question 23

What is suggestive of urethral stricture or a possible carcinoma?

Answer 23

induration of the ventral surface of the penis

Question 24

What is suggestive of periurethral inflammation that is secondary to a urethral stricture?

Answer 24

tenderness in the indurated area

Question 25

What is suggestive of cryptoorchidism (undescended testicle)?

Answer 25

poor developed scrotum on one or both sides of testicles

Question 26

Common scrotal swellings

Answer 26

indirect inguinal hernias, hydroceles, scrotal edema, and testicular carcinoma (rare)

Question 27

Tender, painful scrotal swelling is present in what conditions?

Answer 27

acute epididymitis, acute orchitis, torsion of spermatic cord, or strangulated inguinal hernias

Question 28

any painless nodules in testis must raise a possibility of what condition?

Answer 28

Testicular cancer, a potentially curable cancer with peak incidence between the ages of 15-34 years old

Question 29

varicocele

Answer 29

indicated by multiple tortuous veins in spermatic cord area, usually on the left; may be palpable or even visible

Question 30

Hydrocele of the cord

Answer 30

Indicated by a cystic structure in the spermatic cord

Question 31

Chronically infected vas deferens

Answer 31

May feel thickened or beaded

Question 32

Swelling evaluation by transillumination

Answer 32

Swellings containing serous fluid (hydroceles), light up with a red glow, or transilluminate. Those containing blood or tissue, such as normal testis, a tumor or most hernias do not transilluminate.

Question 33

What is suggestive of a hernia?

Answer 33

A bulge that appears with straining

Question 34

Can you hear bowel sounds over a hernia? Over a hydrocele?

Answer 34

Bowel sounds can be heard over a hernia but not over a hydrocele

Question 35

What is an incarcenated hernia?

Answer 35

Content cannot be returned to the abdominal cavity

Question 36

What is a strangulated hernia?

Answer 36

When blood supply to the entrapped contents is compromised. Suspect in presence of tenderness, nausea, and vomiting; consider surgical intervention

Question 37

What is the most common form of cancer in men between ages 15-34 years old?

Answer 37

testicular carcinoma