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Inflammatory Disorders of the Male

This comprehensive guide covers causes, symptoms, treatments, and complications of male penile inflammatory disorders including urethritis, epididymitis, orchitis, and more, highlighting assessment techniques and preventive measures. Learn about prevention, signs, and management options for conditions such as testicular torsion, hydrocele, varicocele, priapism, hypospadias, cryptorchidism, and the importance of regular testicular exams.

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Inflammatory Disorders of the Male

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  1. Inflammatory Disorders of the Male Penne Mott

  2. Gonococcal /Non Gonococcal (NGU) Urethritis • Causes • Gonorrhea • Chlamydia (NGU)

  3. Gonococcal /Non Gonococcal (NGU) Urethritis • Thick yellowish green purulent discharge • Appears 3 – 14 days after sexual exposure • NGU – scant to moderate amount • Pain in urethra • Redness / irritation

  4. Gonococcal /Non Gonococcal (NGU) Urethritis • Treatment • Rocephin or Zithromax – Gonorrhea • Doxy or tetracycline – Chlamydia • Condom use • Treatment of sex partners

  5. Epididymitis • Convoluted tubules top of each testicle • Inflammation / infection epididymis • High incidence young males

  6. Epididymitis - Causes • Infection – E-coli from lower urinary tract or prostate • Trauma • STD’s – Chlamydia / gonorrhea

  7. Epididymitis - Assessment • “Duck Waddle” walk • Acute painful scrotal swelling (unilateral) • Prehn’s sign – lifting the scrotum onto symphysis relieves pain • NV • Fever / chills • Dysuria, frequency, urgency

  8. Epididymitis - Treatment • Bedrest • Scrotal elevation • Ice • Sitz • Analgesics / antipyretics • Antibiotics • Treatment of STD

  9. Epididymitis - Complications • Epididymal Abscess – may extend testicles • Chronic epididymitis • Tx epididymectomy • Sterility

  10. Orchitis • Rare, acute testicular inflammation • Associated with mumps, pneumonia, TB, syphilis, parasites, trauma • Can be SE • Epididymitis • Mono • Flu • catheterization

  11. Orchitis- Assessment • Red, edematous extremely tender testicles • Fever

  12. Orchitis - Treatment • BR • Scrotal Support • Local heat • Analgesics • Antibiotics • ***Preventable with immunization

  13. Testicular Torsion • Torsion of spermatic cord = twisting of the testis that cuts off blood supply to testis • Adolescent males

  14. Testicular Torsion – S/S • Acute scrotal pain • Nausea • Vomiting • No urinary complaints • U/A – no WBC’s or bacteria • MEDICAL EMERGENCY!!!!

  15. Testicular Torsion - Treatment • Surgery – Surgical exploration of the scrotum & bilateral testicular fixation • Necrosis – orchiectomy

  16. Hydrocele • Collection of fluid between visceral & parietal membranes of the tunica vaginalis (membranes that surrounds the testis)

  17. Hydrocele - Causes • Trauma • Infection (Epididymitis or orthitis) • Cancer of testis • Most commonly occurs • Infants • Males > 40

  18. Hydrocele – S/S • Painless swelling scrotum • Positive transillumination

  19. Hydrocele - Treatment • None unless swelling large & uncomfortable • Fluid aspiration – may be repeated 1-3 mos • Hydocelectomy –excision of membrane

  20. Varicocele • Distention of testicular veins • Infertility

  21. Varicocele – S/S • Wormlike mass “Bag of Worms” above the testis when patient stands • Dragging sensations • Dull aching • Pain relieved by masturbation or sex (relieves venous congestion)

  22. Varicocele - Treatment • Scrotal support • Varicocelectomy • Sclerosing agent injections

  23. Priapism • Prolonged state of erection not associated with sexual desire • Painful • Rare • Urologic emergency

  24. Priapism - Treatment • Ketamine HCL (Ketalar) • Rapid acting nonbarbiturate anesthetic • IM / IV • SE: unpleasant psychic sx. (dreams, hallucinations) vomiting, hypersalivation, skin rashes

  25. Hypospadias • Congential malposition of the meatus on the ventral side of the penis • Associated with infertility

  26. Cryptorchidism • Failure of the testes to descend

  27. Cryptorchidism – S/S • No palpable testes

  28. Cryptorchidism - Treatment • Orchiopexy before age 2-3 • After age 3 increased risk infertility • *Increased risk of Testicular CA

  29. Cryptorchidism – Pre op • Psychologic Problems RT genital surgery in children • Fear / punishment • Body mutilation • Castration

  30. Cryptorchidism – Pre op • The earlier a repair can be made, the more likely the possibility that the child will develop a normal body image • Ideal time 6-15 months

  31. Cryptorchidism – Post op • Care of the surgical site • Tub baths often discouraged 1st week • Catheter care • Restriction of activites –pushing, lifting, playing with staddle toys, sandboxes, rough activites

  32. Testicular Exam • Testicular cancers can occur as early as adolescence • Monthly • Shower – warms the scrotum • Use both hands to palpate scrotal contents • Roll each testicle between thumb and 1st three fingers

  33. Testicular Exam • ID structures • S –permatic cord • V –as deference • E –pididymis • T -estes

  34. Testicular Exam • Testis should feel round soft – hard boiled egg without shell • Epididymis – not as smooth • One testicle may be larger • Spermatic cord -firm smooth • Check – lumps, irregularities, pain, dragging sensations

  35. Testicular Exam • Consult health care provider when abnormalities are discovered

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