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Male Genitourinary Assessment 1

The document provides guidance on assessing the male genitourinary system. It outlines tips for making patients comfortable, questions to ask about medical history, current health issues, sexual health and practices. It describes techniques for physical examination including inspection, percussion, palpation and auscultation of the urinary system, reproductive organs, prostate and inguinal areas. Potential abnormalities that may be uncovered include issues like prostate enlargement, lesions, erectile dysfunction or priapism.

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Rodelyn A. Basid
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165 views4 pages

Male Genitourinary Assessment 1

The document provides guidance on assessing the male genitourinary system. It outlines tips for making patients comfortable, questions to ask about medical history, current health issues, sexual health and practices. It describes techniques for physical examination including inspection, percussion, palpation and auscultation of the urinary system, reproductive organs, prostate and inguinal areas. Potential abnormalities that may be uncovered include issues like prostate enlargement, lesions, erectile dysfunction or priapism.

Uploaded by

Rodelyn A. Basid
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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THE MALE GENITOURINARY ASSESSMENT

A LOOK AT THE MALE GU SYSTEM


● Remember, your patient will take his cue from you. If you’re comfortable discussing his
problem, he’ll be encouraged to talk openly.

OBTAINING A HEALTH HISTORY


Putting your patient at ease

● Here are some tips for helping your patient feel more comfortable during the health
history:
● Make sure that the room is private
● Tell the patient that his answer will remain confidential.
● Start with less sensitive areas
● Don’t rush or omit important information
● Be especially tactful with older men
● When asking questions, keep in mind that many men view sexual problems as a sign of
diminished masculinity. Phrase your questions carefully, and offer reassurance as
needed.
● Consider the patient’s educational and cultural background.

ASKING ABOUT PAST HEALTH AND FAMILY HEALTH


● Ask the patient about his medical history, especially the presence of diabetes or
hypertension
● Inquire about the health of the patient’s family to get information on the patient’s risk of
developing renal failure or kidney disease.

ASKING ABOUT CURRENT HEALTH


● Ask the patient whether he’s circumcised (an inability to retract the prepuce is called
phimosis; an inability to replace it is called paraphimosis)
● Inquire whether the patient has noticed sores, lumps, or ulcers on his penis. These can
signal a sexually transmitted disease (STD)

DRUG CONNECTION
● Some drugs can affect the appearance of urine or alter GU function

ASKING ABOUT SEXUAL HEALTH AND PRACTICES


● Ask the patient about his sexual preference and practices so that you can assess
risk-taking behaviors.

TESTICULAR SELF-EXAMINATION
● During the patient history, ask your patient whether he performs monthly testicular
self-examinations.
TESTICULAR CANCER
● The most common cancer in men ages 20 to 35, can be treated successfully when it’s
detected early.

DON’T FORGET TO ASK ELDERLY PATIENTS


● Most people erroneously believe that sexual performance normally declines with age.
● Some also believe - also erroneously - that elderly people are incapable of having sex,
that they aren’t interested in sex, or that they can’t find other elderly partners who are
interested in sex.

TAKING PRECAUTIONS
● Also ask the patient about his sexual health. Has he ever had trauma to his penis or
scrotum?
● Was he ever diagnosed with an undescended testicle?
● Has he ever had surgery involving his penis or reproductive system?
● Has he ever been diagnosed with a low sperm count?

ASSESSING THE MALE GU SYSTEM


● To perform a physical assessment of the male GU system, use the techniques of
inspection, percussion, palpation, and auscultation.
● Assessment of the urinary system may be done with assessment of the GU system or
as part of the GI assessment

EXAMINING THE URINARY SYSTEM


● Before examining specific structures, check the patient’s blood pressure and weight
● Also, SCAN the skin

INSPECTION
● Watch for abdominal distention with tight, glistening skin and striae (silvery streaks
caused by rapidly developing skin tension) - Signs of ASCITES

PERCUSSION AND PALPATION


● First, tell the patient what you’re going to do; otherwise, he may be startled and you
could mistake his reaction for a feeling of acute tenderness

DULLNESS = RETENTION
● A dull sound instead of the normal tympany may indicate retained urine in the bladder
caused by bladder dysfunction or infection.

PERFORMING FIRST PERCUSSION


● Costovertebral angle

AUSCULTATION
● Auscultate the renal arteries to rule out bruits, which signal artery stenosis
● You can do this during assessment of the GU system or as part of an abdominal
assessment

EXAMINING THE REPRODUCTIVE SYSTEM


● Before examining the reproductive system, put on gloves.
● Make the patients as comfortable as possible, and explain what you’re doing every step
of the way.
● Make sure that the privacy curtain is fully drawn or that the door is closed to help the
patient feel less embarrassed.

INSPECTION
● Inspect the penis, scrotum, and testicles as well as the inguinal and femoral areas

PALPATION
● Palpate the penis, testicles, epididymides, spermatic cords, inguinal and femoral areas,
and prostate gland.

PALPATING THE TESTICLE


● A normal response is a deep visceral pain
● The shadows know
● Inguinal Area
● Femoral Area
○ THREE FINGER TEST/ ZIEMAN’S TECHNIQUE
■ Index finger: deep inguinal ring (indirect hernia)
■ Middle finger: superficial ting (direct hernia)
■ Ring finger: saphenous opening (femoral hernia)

ABNORMAL FINDINGS
● Your assessment may uncover abnormalities of the GU system.
● Although the urinary problems discussed here also occur in women, the causes
described are unique to men.
● Urinary Problems
○ Possible urinary problems include hematuria; urinary frequency, urgency, and
hesitancy; nocturia; and urinary incontinence.

MALE GENITOURINARY SYSTEM


● To remember which findings suggest prostate cancer, think of the mnemonic PAINS:
○ P - rostate cancer
○ A - symmetric
○ I - rregular
○ N - odules
○ S - tony (hard) and fixed
PROSTATE GLAND ENLARGEMENT
● A smooth firm, symmetrical enlargement of the prostate gland indicates benign prostatic
hyperplasia, which typically starts after age 50.
● These findings may be associated with nocturia, urinary hesitancy and frequency, and
recurring UTI’s.
● In acute prostatitis, the prostate gland is firm, warm, and extremely tender and swollen.
Because bacterial infection causes the condition, the patient usually has fever.

PROSTATE GLAND LESIONS


● Hard, irregular, fixed lesions that make the prostate feel asymmetrical suggest prostate
cancer. Palpation may be painful.
● This condition also causes urinary dysfunction. Back and leg pain may occur with bone
metastases in advanced stages.

ERECTILE DYSFUNCTION
● Erectile dysfunction is the inability to achieve and maintain penile erection sufficient to
complete satisfactory sexual intercourse; ejaculation may or may not be affected.

PRIAPISM
● A urologic emergency, priapism is a persistent, painful erection that’s unrelated to sexual
excitation. It may last for several hours or days and is usually accompanied by a severe,
constant, dull aching in the penis.

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