Assessment of the Male
Genitourinary System
Health Assessment Across the
Lifespan
NRS 102
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Chapter 24: Male Genitourinary System

Structure and Function

Subjective Data—Health History Questions

Objective Data—The Physical Exam

Abnormal Findings
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-2
Chapter 24: Male Genitourinary System
Structure and Function
Penis

Corpora
cavernosa

Corpora
spongiosum

Glans

Corona

Urethra

Foreskin
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-3
Chapter 24: Male Genitourinary System
Scrotum

Rugae

Cremaster muscle

Testis

Epididymis

Vas deferens

Spermatic cord

Ejaculatory duct
Copyright Connie Cooper
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-4
Chapter 24: Male Genitourinary System
Structure and Function
(cont.)

Inguinal area

Inguinal
ligament

Inguinal canal


Internal ring

External ring
Femoral canal
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-5
Chapter 24: Male Genitourinary System
Subjective Data—
Health History Questions

Frequency, urgency, and nocturia

Dysuria

Hesitancy and straining

Urine color

Genitourinary history
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-6
Chapter 24: Male Genitourinary System
Subjective Data—
Health History Questions
(cont.)

Penis—pain, lesion, and/or discharge

Scrotum—self-care behaviors; lump

Sexual activity and contraceptive use

Sexually transmitted disease contact
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-7
Chapter 24: Male Genitourinary System
Principles of interviewing
adolescent male patients:





Ask questions that seem appropriate for boy’s 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
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-8
Chapter 24: Male Genitourinary System
Additional History for
Preadolescents and Adolescents

Around age 12 to 13 years…

Who can you talk to…

Boys around age 12 to 13 years have a
normal experience…

Teenage boys have other normal
experiences and wonder if they are the only
ones who ever had them…
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-9
Chapter 24: Male Genitourinary System
Additional History
(cont.)

Often boys your age have questions about
sexual activity.…

Has a nurse or doctor ever taught you…

Has anyone ever touched your genitals…
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-10
Chapter 24: Male Genitourinary System
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…
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-11
Chapter 24: Male Genitourinary System
Objective Data—The Physical Exam


Preparation

Position

Apprehension regarding exam
Equipment needed

Gloves

Occasionally need
• Glass slide for urethral specimen
• Materials for cytology
• Flashlight
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-12
Chapter 24: Male Genitourinary System
Objective Data—The Physical Exam
(cont.)

Penis—Inspect and palpate

Skin

Glans

Urethral meatus

Pubic hair

Urethral discharge

Shaft
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-13
Chapter 24: Male Genitourinary System
Objective Data—The Physical Exam
(cont.)

Scrotum—Inspect and palpate

Skin

Testis

Epididymis

Spermatic cord

Any mass

Note characteristics

Transillumination
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-14
Chapter 24: Male Genitourinary System
Objective Data—The Physical Exam
(cont.)

Check for hernia—Inspect
and palpate




Person standing and
straining down
Palpation technique
Inguinal lymph nodes
Teach testicular selfexamination
T = Timing
S = Shower
E = Examination points
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-15
Chapter 24: Male Genitourinary System
Sample Charting
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-16
Chapter 24: Male Genitourinary System
Sample Charting
(cont.)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-17
Chapter 24: Male Genitourinary System
Abnormal Findings
Male Genital Lesions

Herpes progenitalis

Syphilitic chancre

Condylomata acuminata (genital warts)

Carcinoma

Urethritis (urethral discharge and dysuria)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-18
Chapter 24: Male Genitourinary System
Abnormal Findings
(cont.)
Abnormalities of the Penis

Phimosis

Paraphimosis

Hypospadias

Epispadias

Peyronie’s disease

Priapism

Urethral stricture
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-19
Chapter 24: Male Genitourinary System
Abnormal Findings
(cont.)
Abnormalities in the Scrotum

Absent testis; cryptorchidism

Small testis

Testicular torsion

Epididymitis

Spermatic cord varicocele

Spermatocele
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-20
Chapter 24: Male Genitourinary System
Abnormal Findings
(cont.)
Abnormalities in the Scrotum

Early testicular tumor

Diffuse tumor

Hydrocele

Scrotal hernia

Orchitis

Scrotal edema
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-21
Chapter 24: Male Genitourinary System
Abnormal Findings
(cont.)
Inguinal and Femoral Hernias

Indirect inguinal

Direct inguinal

Femoral
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-22
Chapter 24: Male Genitourinary System
Which of the following introductions would
be the best way to start your question
when interviewing an adolescent?
A. Often young men your age…
B. I worry that you might…
C. Do you…
D. You don’t…do you?
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-23
Chapter 24: Male Genitourinary System
Which of the following topics will be least
embarrassing to a male patient?
A. Elimination (urination)
B. Sexual function
C. Reproduction
D. Sexually transmitted infection exposure
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 24-24