Diagnostic Tests for Male sexual conditions
Male sexual conditions Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Male sexual conditions:
- Home STD Testing
- Sexuality & Libido: Home Testing:
- Liver Health & Hepatitis: Home Testing
Male sexual conditions Diagnosis: Book Excerpts
Diagnostic Tests for Male sexual conditions: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Male sexual conditions.
IMPOTENCE:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
A thorough psychiatric and sexual history is necessary before undertaking expensive laboratory tests. It is wise to interview the spouse or sexual partner also because the symptom may be exaggerated by the patient. Do not hesitate to order a drug screen. Routine tests include a CBC and differential count, a urinalysis, a urine culture and colony count, a chemistry panel, VDRL test, thyroid profile, serum testosterone, and gonadotrophin assay. A referral to a urologist is probably wise at this point. He will work up the patient further with a nocturnal tumescent study, Doppler ultrasonography, and penile blood pressure studies. In addition, he may want to do a cystoscopy. It may be wise to perform a postage stamp test before referral for a formal tumescence study.
Nerve conduction velocity studies and EMGs may be needed to rule out diabetic neuropathy. MRI of the spine, cystometric studies, and SSEP studies will help to rule out multiple sclerosis and other spinal cord lesions. A sacral reflex latency time may be very helpful in diagnosing sacral nerve injury. A spinal tap may help rule out central nervous system lues. Angiography may be needed to exclude a Leriche's syndrome.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
PRIAPISM:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
The basic workup includes a CBC, sedimentation rate, urinalysis, urine culture and colony count, sickle cell preparation, coagulation profile, chemistry panel, and serum protein electrophoresis. A urologist should also be consulted.
If there are neurologic signs, MRI of the brain or appropriate level of the spinal cord should probably be done. However, a neurologist should be consulted before ordering these expensive tests. A spinal tap will be helpful in diagnosing multiple sclerosis and central nervous system syphilis.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
SCROTAL SWELLING:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Routine laboratory tests include a CBC, sedimentation rate, urinalysis, urine culture, and urethral smear. If prostatic disease is suspected, a PSA should be ordered. If intestinal obstruction is suspected, a flat plate of the abdomen and lateral decubiti should be ordered. A radionuclide testicular scan with technetium-99m is useful in differentiating between testicular torsion and epididymitis. Scrotal ultrasound may be done to evaluate any kind of testicular or scrotal mass. However, it is much less costly to refer the patient to a urologist.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Impotence:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient complains of impotence or of a condition that may be causing it, let him describe his problem without interruption. Then begin your examination in a systematic way, moving from less sensitive to more sensitive matters. Begin with a psychosocial history. Is the patient married, single, or widowed? How long has he been married or had a sexual relationship? What’s the age and health status of his sexual partner? Is he feeling stress or pressure from his partner to conceive a child? Find out about past marriages, if any, and ask him why he thinks they ended. If you can do so discreetly, ask about sexual activity outside marriage or his primary sexual relationship. Also ask about his job history, his typical daily activities, and his living situation. How well does he get along with others in his household?
Focus your medical history on the causes of erectile dysfunction. Does the patient have type 2 diabetes mellitus, hypertension, or heart disease? If so, ask about its onset and treatment. Also ask about neurologic diseases such as multiple sclerosis. Obtain a surgical history, emphasizing neurologic, vascular, and urologic surgery. If trauma may be causing the patient’s impotence, find out the date of the injury as well as its severity, associated effects, and treatment. Ask about alcohol intake, drug use or abuse, smoking, diet, and exercise. Obtain a urologic history, including voiding problems and past injury.
Next, ask the patient when his impotence began. How did it progress? What’s its current status? Make your questions specific, but remember that he may have difficulty discussing sexual problems or may not understand the physiology involved.
The following sample questions may yield helpful data: When was the first time you remember not being able to initiate or maintain an erection? How often do you wake in the morning or at night with an erection? Do you have wet dreams? Has your sexual drive changed? How often do you try to have intercourse with your partner? How often would you like to? Can you ejaculate with or without an erection? Do you experience orgasm with ejaculation?
Ask the patient to rate the quality of a typical erection on a scale of 0 to 10, with 0 being completely flaccid and 10 being completely erect. Using the same scale, also ask him to rate his ability to ejaculate during sexual activity, with 0 being never and 10 being always.
Next, perform a brief physical examination. Inspect and palpate the genitalia and prostate for structural abnormalities. Assess the patient’s sensory function, concentrating on the perineal area. Next, test motor strength and deep tendon reflexes in all extremities, and note other neurologic deficits. Take the patient’s vital signs and palpate his pulses for quality. Note any signs of peripheral vascular disease, such as cyanosis and cool extremities. Auscultate for abdominal aortic, femoral, carotid, or iliac bruits, and palpate for thyroid gland enlargement.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Priapism:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient’s condition permits, ask him when the priapism began. Is it continuous or intermittent? Has he had a prolonged erection before? If so, what did he do to relieve it? How long did he remain detumescent? Does he have pain or tenderness when he urinates? Has he noticed changes in sexual function?
Explore the patient’s medical history. If he reports sickle cell anemia, find out about factors that could precipitate a crisis, such as dehydration and infection. Ask if he has recently suffered genital trauma, and obtain a thorough drug history. Ask if he has had drugs injected or objects inserted into his penis.
Examine the patient’s penis, noting its color and temperature. Check for loss of sensation and signs of infection, such as redness or drainage. Finally, take his vital signs, particularly noting a fever.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Scrotal swelling:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient isn’t in distress, proceed with the history. Ask about injury to the scrotum, urethral discharge, cloudy urine, increased urinary frequency, and dysuria. Is the patient sexually active? When was his last sexual contact? Does he have a history of sexually transmitted disease? Find out about recent illnesses, particularly mumps. Does he have a history of prostate surgery or prolonged catheterization? Does changing his body position or level of activity affect the swelling?
Take the patient’s vital signs, especially noting a fever, and palpate his abdomen for tenderness. Then examine the entire genital area. Assess the scrotum with the patient supine and standing. Note its size and color. Is the swelling unilateral or bilateral? Do you see signs of trauma or bruising? Are there rashes or lesions present? Gently palpate the scrotum for a cyst or lump. Note especially tenderness or increased firmness. Check the testicles’position in the scrotum. Finally, transilluminate the scrotum to distinguish a fluid-filled cyst from a solid mass. (A solid mass can’t be transilluminated.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Genital lesions in the male:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Begin by asking the patient when he first noticed the lesion. Did it erupt after he began taking a new drug or after a trip out of the country? Has he had similar lesions before? If so, did he get medical treatment for them? Find out if he has been treating the lesion himself. If so, how? Does the lesion itch? If so, is the itching constant or does it bother him only at night? Note whether the lesion is painful. Ask for a description of any drainage from the lesions. Next, take a complete sexual history, noting the frequency of relations, number of sexual partners, and pattern of condom use.
Before you examine the patient, observe his clothing. Do his pants fit properly? Tight pants or underwear, especially those made of nonabsorbent fabrics, can promote the growth of bacteria and fungi. Examine the entire skin surface, noting the location, size, color, and pattern of the lesions. Do genital lesions resemble lesions on other parts of the body? Palpate for nodules, masses, and tenderness. Also, look for bleeding, edema, or signs of infection, such as purulent drainage or erythema. Finally, take the patient’s vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Introduction: Sexual Disorders:
Physical assessment
(Professional Guide to Diseases (Eighth Edition))
Physical assessment, primarily a diagnostic tool, can also serve as an excellent opportunity for patient teaching.
❑ During examination of the female, evaluate breast development, pubic hair distribution, and the development of external genitalia. With gloved hands, use a speculum to examine internal genitalia, including the cervix and vagina. Palpate the uterus and ovaries.
ELDER TIP Take special care when examining an older woman because atrophic changes of the vaginal mucosa may increase her discomfort during a pelvic examination. Use a small speculum because of the decreased vaginal size. To ease insertion, dampen the speculum with warm water; don’t use a lubricant because it may alter Papanicolaou test results. Proceed slowly; abrupt insertion of the speculum may damage sensitive degenerating tissue.
❑ During examination of the male, check pubic and axillary hair distribution. With a gloved hand, palpate the penis, scrotum, prostate gland, and rectum. Inspect the penis (shaft, glans, and urethral meatus) for lesions, swelling, inflammation, scars, or discharge. In the uncircumcised male, retract the foreskin to visualize the glans. Examine the scrotum for size, shape, and abnormalities, such as nodules or inflammation. Check for the presence of both testes (the left testis is typically lower than the right).
ELDER TIP The testes of an older male may be slightly smaller than those of a younger male, but they should be equal in size, smooth, freely moveable, and soft without nodules.
❑ Inspect and palpate the inguinal canal; you shouldn’t observe any bulging of tissues or organs. (See Male sexual anatomy, page 994.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Impotence:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient complains of impotence or of a condition that may be causing it, let him describe his problem without interruption. Then begin your examination in a systematic way, moving from less sensitive to more sensitive matters. Begin with a psychosocial history. Is the patient married, single, or widowed? How long has he been married or had a sexual relationship? What’s the age and health status of his sexual partner? Find out about past marriages, if any, and ask him why he thinks they ended. If you can do so discreetly, ask about sexual activity outside marriage or his primary sexual relationship. Also ask about his job history, his typical daily activities, and his living situation. How well does he get along with others in his household?
Focus your medical history on the causes of erectile dysfunction. Does the patient have type 2 diabetes mellitus, hypertension, or heart disease? If so, ask about its onset and treatment. Also ask about neurologic diseases such as multiple sclerosis. Obtain a surgical history, emphasizing neurologic, vascular, and urologic surgery. If trauma may be causing the patient’s impotence, find out the date of the injury as well as its severity, associated effects, and treatment. Ask about intake of alcohol, drug use or abuse, smoking, diet, and exercise. Obtain a urologic history, including voiding problems and past injury.
Next, ask the patient when his impotence began. How did it progress? What’s its current status? Make your questions specific, but remember that many patients have difficulty discussing sexual problems, and many don’t understand the physiology involved.
The following sample questions may yield helpful data: When was the first time you remember not being able to initiate or maintain an erection? How often do you wake in the morning or at night with an erection? Do you have wet dreams? Has your sexual drive changed? How often do you try to have intercourse with your partner? How often would you like to? Can you ejaculate with or without an erection? Do you experience orgasm with ejaculation?
Ask the patient to rate the quality of a typical erection on a scale of 0 to 10, with 0 being completely flaccid and 10 being completely erect. Using the same scale, also ask him to rate his ability to ejaculate during sexual activity, with 0 being never and 10 being always.
Next, perform a brief physical examination. Inspect and palpate the genitalia and prostate for structural abnormalities. Assess the patient’s sensory function, concentrating on the perineal area. Next, test motor strength and deep tendon reflexes in all extremities, and note other neurologic deficits. Take the patient’s vital signs and palpate his pulses for quality. Note any signs of peripheral vascular disease, such as cyanosis and cool extremities. Auscultate for abdominal aortic, femoral, carotid, or iliac bruits, and palpate for thyroid gland enlargement.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Priapism:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s condition permits, ask him when the priapism began. Is it continuous or intermittent? Has he had a prolonged erection before? If so, what did he do to relieve it? How long did he remain detumescent? Does he have pain or tenderness when he urinates? Has he noticed any changes in sexual function?
Explore the patient’s medical history. If he reports sickle cell anemia, find out about any factors that could precipitate a crisis, such as dehydration and infection.Ask if he has recently suffered genital trauma, and obtain a thorough drug history. Ask if he has had any drugs injected or objects inserted into his penis.
Examine the patient’s penis, noting its color and temperature. Check for loss of sensation and signs of infection, such as redness or drainage. Finally, take his vital signs, particularly noting fever.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Scrotal swelling:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient isn’t in distress, proceed with the history. Ask about injury to the scrotum, urethral discharge, cloudy urine, increased urinary frequency, and dysuria. Is the patient sexually active? When was his last sexual contact? Does he have a history of sexually transmitted disease? Find out about recent illnesses, particularly mumps. Does he have a history of prostate surgery or prolonged catheterization? Does changing his body position or level of activity affect the swelling?
Take the patient’s vital signs, especially noting fever, and palpate his abdomen for tenderness. Then examine the entire genital area. Assess the scrotum with the patient in supine and standing positions. Note its size and color. Is the swelling unilateral or bilateral? Do you see signs of trauma or bruising? Are there rashes or lesions present? Gently palpate the scrotum for a cyst or a lump. Note especially tenderness or increased firmness. Check the testicles’position in the scrotum. Finally, transilluminate the scrotum to distinguish a fluid-filled cyst from a solid mass. (A solid mass can’t be transilluminated.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Genital lesions in the male:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Begin by asking the patient when he first noticed the lesion. Did it erupt after he began taking a new drug or after a trip out of the country? Has he had similar lesions before? If so, did he get medical treatment for them? Find out if he has been treating the lesion himself. If so, how? Does the lesion itch? If so, is the itching constant or does it bother him only at night? Note whether the lesion is painful. Ask for a description of any drainage from the lesion. Next, take a complete sexual history, noting the frequency of relations, the number of sexual partners, and the pattern of condom use.
Before you examine the patient, observe his clothing. Do his pants fit properly? Tight pants or underwear, especially those made of nonabsorbent fabrics, can promote the growth of bacteria and fungi. Examine the entire skin surface, noting the location, size, color, and pattern of the lesions. Do genital lesions resemble lesions on other parts of the body? Palpate for nodules, masses, and tenderness. Also, look for bleeding, edema, or signs of infection, such as purulent drainage or erythema. Finally, take the patient’s vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Impotence:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
Although physical examination is usually not enlightening, general agreement is seen that the genitals should be examined for evidence of overt testicular atrophy, and the penis for Peyronie’s disease. In the latter, inflammatory plaques in the corpora cavernosa produce an area of limited expansile capacity, with subsequent penile deviation on erection which can prevent intromission. A rectal examination to document rectal sensation as well as tone can be complemented by the bulbocavernosus reflex. This reflex is elicited by briskly squeezing the glans penis in one hand while a single digit from the other is in the rectum. A normal examination, indicating an intact reflex arc, is manifest as a rectal contraction in response to the glans squeeze. Prostate examination is pertinent at this point, in the event testosterone therapy is required.
Testing
Reasonable screening tests for impotence include a complete blood cell count, testosterone level, and a urinalysis. If testosterone is low, luteinizing hormone and follicle stimulating hormone levels should be measured, as an increase in either of these indicates gonadal failure, for which testosterone replacement is indicated; a decrease, however, indicates hypothalamic or pituitary insufficiency, necessitating central nervous system imaging to rule out a mass lesion. Similarly, low testosterone merits a serum prolactin level, as elevations of prolactin result in testosterone suppression. Other diagnostic testing, such as penile Doppler flow or nocturnal penile tumescence testing, add little to the options for therapy, but much to the expense.
Diagnostic assessment
In primary care, 98% of patients will have no testosterone deficiency, prolactin excess, or physical abnormalities (1). Such patients should be reassured that although they have no readily correctable cause for their impotence, effective therapy can be immediately begun. Patients who fail to respond to the standard tools for potency restoration (oral agents, vacuum constriction devices, and so on), or who desire more definitive delineation of their underlying pathology (as might be determined by Doppler studies) should be referred to specialty diagnostic centers.
Reference
1. Kuritzky L, Ahmed O, Kosch S. Management of impotence in primary care. Compr Ther 1998;24(3):137–146.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Priapism:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
should include a thorough genitourinary examination to look for trauma or malignancy. The corpora cavernosa, but not the corpora spongiosum, is involved with priapism and, therefore, the glans will remain flaccid while the shaft is erect and tender. Also palpate for inguinal lymphadenopathy [genitourinary (GU) malignancy], and examine the abdomen (abdominal or GU malignancy and trauma).
Testing
A. Clinical laboratory tests. In most instances, the history and physical examination will determine the cause of priapism. A complete blood count and sickle cell screen may be useful, looking for malignancy and sickle cell disease, respectively. Coagulation studies are also recommended (in case aspiration is contemplated for treatment) (5).
B. Diagnostic imaging, in most instances, is not needed. With suspicion of pelvic malignancy, computed tomography is generally the next step. If trauma preceded priapism, arteriography may be indicated.
Diagnostic assessment
The key to determining the cause of priapism is the clinical history. Examination will reveal an erect, usually tender penis with flaccid glans. Distinguish early between arterial and veno-occlusive priapism; the former is often associated with trauma and less painful or painless erections. In evaluating priapism, aim at determining how long it has been present because permanent damage can occur within as little as 4 hours, and what is causing it. The most common causes are result from effects of psychotropic medications or medications for ED. Less common causes include trauma, sickle cell disease, and pelvic malignancy. Priapism is considered a urologic emergency and should be managed aggressively. Treatment within 4 to 6 hours of onset has been shown to decrease morbidity, need for invasive procedures, and impotence (2).
References
1. Brock G, Breza J, Lue TF, et al. High flow priapism: a spectrum of disease. J Urol 1993;150:968–971.
2. Thompson JW Jr, Ware MR, Blashfield RK. Psychotropic medication and priapism: a comprehensive review. J Clin Psychiatry 1990;51:430–433.
3. Broderick GA. Intracavernous pharmacotherapy—treatment for the aging erectile response. Urol Clin North Am 1996;23:111–126.
4. Chan PT, Begin LR, Arnold D, et al. Priapism secondary to penile metastasis: a report of two cases and a review of the literature. J Surg Oncol 1998;68:51–59.
5. Samm BJ, Dmochowski RR. Urologic emergencies. Postgrad Med 1996;100:187–200.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Scrotal Pain/Swelling:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
Testicular torsion, a medical emergency, should be the primary consideration in a patient with an acutely painful scrotum; however, epididymitis is a more common cause than torsion by 10:1. Reduction in pain by manual elevation of the testicle (Phren sign) helps to distinguish epididymitis from testicular torsion. A cremasteric reflex is absent in testicular torsion but present in torsion of the appendix testis.
Testicular cancer must be definitively ruled out whenever a firm induration or mass is found to be contiguous with the testicle.
Referred pain can be differentiated from scrotal pathology by a normal testicular examination.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Scrotal swelling:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Take the patient’s vital signs, especially noting fever, and palpate his abdomen for tenderness. Then examine the entire genital area. Assess the scrotum with the patient in supine and standing positions. Note its size and color. Is the swelling unilateral or bilateral? Do you see signs of trauma or bruising? Are there rashes or lesions present? Gently palpate the scrotum for a cyst or a lump. Note especially tenderness or increased firmness. Check the testicles’position in the scrotum. Finally, transilluminate the scrotum to distinguish a fluid-filled cyst from a solid mass. (A solid mass can’t be transilluminated.)
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Genital lesions in the male:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Before you examine the patient, observe his clothing. Do his pants fit properly? Tight pants or underwear, especially those made of nonabsorbent fabrics, can promote the growth of bacteria and fungi. Examine the entire skin surface, noting the location, size, color, and pattern of the lesions. Do genital lesions resemble lesions on other parts of the body? Palpate for nodules, masses, and tenderness. Also, look for bleeding, edema, or signs of infection, such as purulent drainage or erythema. Finally, take the patient’s vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Impotence:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient complains of impotence or of a condition that may be causing it, let him describe his problem without interruption. Then begin your examination with a psychosocial history. Is the patient married, single, or widowed? How long has he been married or had a sexual relationship? What's the age and health status of his sexual partner? Is he feeling stress or pressure from his partner to conceive a child? Find out about past marriages, if any, and ask him about his sexual experiences with former spouses. Ask about sexual activity outside marriage or his primary sexual relationship. Also ask about his job history, his typical daily activities, and his living situation. How well does he get along with others in his household?
Focus your medical history on the causes of erectile dysfunction. Does the patient have diabetes mellitus, hypertension, or heart disease? If so, ask about its onset and treatment. Also ask about neurologic diseases such as multiple sclerosis. Obtain a surgical history, emphasizing neurologic, vascular, and urologic surgery. If trauma may be causing the patient's impotence, find out the date of the injury as well as its severity, associated effects, and treatment. Ask about alcohol intake, drug use or abuse, smoking, diet, and exercise. Obtain a urologic history, including voiding problems and past injury.
Next, ask the patient when his impotence began. How did it progress? What's its current status? Make your questions specific, but remember that he may have difficulty discussing sexual problems or may not understand the physiology involved.
Other questions that can help yield helpful data include: When was the first time you remember not being able to initiate or maintain an erection? How often do you wake in the morning or at night with an erection? Do you have wet dreams? Has your sexual drive changed? How often do you try to have intercourse with your partner? How often would you like to? Can you ejaculate with or without an erection? Do you experience orgasm with ejaculation?
Next, perform a brief physical examination. Inspect and palpate the genitalia and prostate for structural abnormalities. Assess the patient's sensory function, concentrating on the perineal area. Next, test motor strength and deep tendon reflexes in all extremities, and note other neurologic deficits. Take the patient's vital signs and palpate his pulses for quality. Note any signs of peripheral vascular disease, such as cyanosis and cool extremities. Auscultate for abdominal aortic, femoral, carotid, or iliac bruits, and palpate for thyroid gland enlargement.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Priapism:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Ask the patient when the priapism began. Is it continuous or intermittent? Has he had a prolonged erection before? If so, what did he do to relieve it? How long did he remain detumescent? Does he have pain or tenderness when he urinates? Has he noticed changes in sexual function?
Explore the patient's medical history. If he reports sickle cell anemia, find out about factors that could precipitate a crisis, such as dehydration and infection. Ask if he has recently suffered genital trauma, and obtain a thorough drug history. Ask if he has had drugs injected or objects inserted into his penis. Obtain a complete drug history. Note use of medications for erectile dysfunction (ED) (phosphodiesterase inhibitors).
Examine the patient's penis, noting its color and temperature. Check for loss of sensation and signs of infection, such as redness or drainage. Finally, take his vital signs, particularly noting a fever.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Scrotal swelling:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient isn't in distress, proceed with the history. Ask about injury to the scrotum, urethral discharge, cloudy urine, increased urinary frequency, and dysuria. Is the patient sexually active? When was his last sexual contact? Does he have a history of sexually transmitted disease? Find out about recent illnesses, particularly mumps. Does he have a history of prostate surgery or prolonged catheterization? Does changing his body position or level of activity affect the swelling?
Take the patient's vital signs, especially noting fever, and palpate his abdomen for tenderness. Then examine the entire genital area. Assess the scrotum with the patient in a supine position and standing. Note its size and color. Is the swelling unilateral or bilateral? Do you see signs of trauma or bruising? Are there rashes or lesions present? Gently palpate the scrotum for a cyst or lump. Note especially tenderness or increased firmness. Check the testicles'position in the scrotum. Finally, transilluminate the scrotum to distinguish a fluid-filled cyst from a solid mass. (A solid mass can't be transilluminated.)
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Genital lesions, male:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Begin by asking the patient when he first noticed the lesion. Did it erupt after he began taking a new drug or after a trip out of the country? Has he had similar lesions before? If so, did he get medical treatment for them? Find out if he has been treating the lesion himself. If so, how? Does the lesion itch? If so, is the itching constant or does it bother him only at night? Note whether the lesion is painful. Ask for a description of any drainage from the lesion. Next, take a complete sexual history, noting the frequency of relations, number of sexual partners, and pattern of condom use.
Before you examine the patient, observe his clothing. Do his pants fit properly? Tight pants or underwear, especially those made of nonabsorbent fabrics, can promote the growth of bacteria and fungi. Examine the entire skin surface, noting the location, size, color, and pattern of the lesions. Do genital lesions resemble lesions on other parts of the body? Palpate for nodules, masses, and tenderness. Also, look for bleeding, edema, or signs of infection, such as purulent drainage or erythema. Finally, take the patient's vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
By now, ViagraTM has become virtually a household name. But there are many possible causes of erectile dysfunction and various treatment options for...
Despite what many people think, elder women can lead healthy and active sexual lives. But this doesn't mean it will always be easy. Our panel...
In many people's eyes, advanced age and sexual intimacy go together like milk and orange juice. But sexuality can be an important part of any...
In many people's eyes, advanced age and sexual intimacy go together like milk and orange juice. But sexuality can be an important part of any...
See full list of 15 related videos
» Next page: Diagnosis of Male sexual conditions
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
