1. Disorders of the Male Genitalia
Gender Health

2. 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

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

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

10. 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

11. 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

12. 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)

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

14. 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

15. 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.

16. 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.

17. Later this term: AIDS, a real life story