Disorders of the Male Genitalia Gender Health

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

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

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

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/won’t heal Peyronie Disease- fibrous band in the corpus cavernosum. Deviation of penis.

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

Testicular Swelling: Torsion 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

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

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

HPV (Genital warts) 5.5 million new cases/year in US No cure (viral) Many people have the virus and don’t know Smoking, drug, or alcohol abuse interferes with body’s 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

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

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)

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

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

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.

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.

Later this term: AIDS, a real life story