MALE GENITALIA

SYMPTOMS:

DYSURIA: Uncomfortable or painful urination
- Pain with urination: Urethritis, urethral obstruction, prostatitis.
- Pain felt after urination: bladder calculus, prostatitis.
FREQUENCY of URINATION:
URGENCY:
NOCTURIA:
POLYURIA:
URINARY INCONTINENCE:
HEMATURIA:
- Time of Hematuria:
  - Beginning of micturition: urethral or prostatic source. Blood is originating near the meatus.
  - Throughout micturitiuon: renal source. Blood is diffusely present in urine.
  - End of micturition: bladder source. Blood is originating from bladder.
- Painless Hematuria: Think neoplasms (renal or bladder), renal tuberculosis, acute glomerulo-nephritis.
OLIGURIA, ANURIA: Renal failure.
- Oliguria: 24-hr urine output less than 400 ml
- Anuria: 24-hr urine output less than 100 ml
PNEUMATURIA: Passage of air or stool through urinary tract. It indicates the presence of fistula tracts connecting the GI and UG tracts, such as after surgery or with inflammatory bowel disease.
PROSTATISM: No direct relationship exists between voiding habits and feelings of urgency, and the size of Benign Prostatic Hyperplasia.
PENILE PAIN, ULCERS, DISCHARGE:
- Phimosis: Constriction of the penis, causing pain in uncircumcised penises.
LOSS of LIBIDO, IMPOTENCE:
INFERTILITY:
SCROTAL SWELLING, TESTICULAR PAIN: Testicular pain is usually caused by torsion, hydrocele, varicocele, or spermatocele. Testicular tumors are usually painless when they present.

PHYSICAL EXAM:

PENIS
- Balanitis: Inflammation of the glans penis. Causes:
  - Diabetes mellitus
  - Infections: Candida, Trichomonas
  - Drug reactions
  - Reiter's Syndrome
- Peyronie's Disease: Lateral deviation of penis, caused by unilateral inflammation of a corpus cavernosum.
SCROTUM
- Atrophic Testes: Caused by orchitis, trauma, chronic alcoholism, cirrhosis.
- Hydrocele: Transillumination of a scrotal mass will illumiunate a hydrocele. If a painful mass is present, transilluminate it.
PROSTATE
INGUINAL CANALS and GROIN: See abdominal study guide.
RECTAL EXAM