Disorders of the Male Genitalia

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Disorders of the Male Genitalia

• Gender Health

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Vocabulary Words-Alphabetical

• Balanitis-Bacterial or fungal infection in
  uncircumcised males swelling of the glans often
  seen with phimosis, in poorly controlled
  diabetes, or in Candida infection.
• Balanoposthitis-inflammation of the glans and
  prepuce

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Cancers of the male genital

• Penile-increased risk in uncircumcised males, and
  with poor hygiene HPV infection can cause penile
  CA
• Testicular-increased risk in cryptorchidism with
  elevated testicular temperature

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• Cryptorchidism-Failure of one or both testes to
  descend into the scrotum
• Epispadius-Congenital defect resulting in the
  urethra opening on the dorsum of the penis
• Hydrocele-Non-tender, smooth, firm mass Fluid
  filled scrotum.
• Hypospadius-Congenital defect with urethral
  opening on the ventral surface of the penis,
  rather than on the glans

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• Klinefelter Syndrome-Xxy hypogonadism, small
  scrotum, female pubic hair pattern, gynecomastia
• Paraphimosis-inability to replace foreskin, once
  retracted
• Penile Cancer- squamous cell CA uncircum males
  painless ulceration/wont heal
• Peyronie Disease- fibrous band in the corpus
  cavernosum. Deviation of penis.

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• Phimosis-tight foreskin will not retract over
  glans
• Priapism-prolonged, often painful erection.
  Idiopathic or seen with hemoglobinopathies like
  sickle cell anemia, or in leukemia

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Testicular SwellingTorsion Epididymitis

• Twisting of testis on spermatic cord
• Babies to teens
• Acute pain
• Vomiting, nausea
• Scrotal discoloration
• Lack of cremasteric reflex
• Surgical emergency

• Bacterial infection (STD or UTI)
• Teens to adults
• Gradual onset of pain
• Fever
• Dysuria, pyuria
• Redness of scrotum
• Urethral discharge
• Nodular epididymus

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• Smegma-sebacious material secreted by the glans
  penis and epithelium desquamated from the prepuce
• Spermatocele-cystic swelling of the epididymus.
  Does transilluminate
• Testicular tumor- usually malignant fixed non
  tender mass that does not transilluminate.
• Varicocele-dilation and torsion of spermatic cord
  veins/scrotal swelling

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Common STDs

• Herpes
• HPV-Condyloma Acuminata-Genital warts
• Chlamydia-Lymphogranuloma Venereum
• Syphilis
• Gonorrhea
• HIV/AIDS

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HPV (Genital warts)

• 5.5 million new cases/year in US
• No cure (viral)
• Many people have the virus and dont know
• Smoking, drug, or alcohol abuse interferes with
  bodys normal defense against this virus
• Soft, reddish or flesh tone raised lesions on
  glans, penis, or inside urethral meatus
  (condlyoma acuminatum)
• Causes malignant changes Penile Cancer

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Chlamydia (Lymphogranuloma Venerium)

• 3 Million new cases/yr in US
• Curable
• Painless erosion at or near coronal sulcus
  (glans) Mucous plug before AM urination
• Lymph node involvement-lymphedema
• Symptoms may become systemic Scrotal swelling,
  fever, epididymitis
• May impact fertility

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Herpes

• 1 million NEW cases/yr. in US
• No cure viral
• Painful or itchy vesicular lesions
• Lesions recur again and again
• Lymphadenopathy
• Fever, upon initial infection (maybe)

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Gonorrhea

• 650,000 new cases/yr in US
• Curable- antibiotics
• Watery or purulent discharge from penis
• Urethral meatus may be red or swollen

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Syphilis

• 70,000 new cases/yr in US
• Curable antibiotic therapy
• Syphilitic chancre
• Painless lesion
• Usually on glans
• 2 wks after exposure lesions appear
• Decades later, nervous and musculoskeletal
  damage

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Formative assessment

• What are the 3 most common STDs in males in the
  US?
• List 3 curable and 3 incurable STDs
• How can you tell the difference between
  testicular torsion and and epididymitis?
• At what age would phimosis be a normal finding?
• List one risk factor for penile cancer.

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Review questions

• A patient with muscle and joint pain whose
  prostate is painful and warm on palpation is most
  likely suffering from _________.
• An elderly patient with urinary dribbling is most
  likely suffering from ____________.
• List 3 risk factors for prostate cancer.

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Later this term AIDS, a real life story
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