Question

Discuss the assessment techniques of genitourinary system in the adult male and include one usual abnormal findings

Answer 1

1. Genitourinary system :

Genitourinary system involves the organs of urinary system and reproductive system . Kidneys , bladder, urethra , testis , epididymis , seminal ducts and other accessory organs are included under the genitourinary system .

Assessment techniques of genitourinary system:

Thorough history collection and physical examination is important in assessment of genitourinary system

History collection :

1. Allow the person to express his sexual or psychosexual problems
2. Ask questions regarding : urinary problems like difficulty in passing urine , colour , odour , frequency of micturition , dribbling of urine or any urinary incontinence
3. Urethral problems like dysuria , sexually transmitted disease
4. Testicular pain , trauma , associated symptoms like mumps
5. Genital ulcers
6. Infertility history or usage of any medications
7. Occupational history of working at any chemical factories
8. Family history of any kidney failure or polycystic kidney disease
9. Past medical history or surgical history like usage of medications for hypertension , any kidney disease and previous prostate surgery

General examination :

​​​​​​General examination is usually is done by Inspection , palpation , percussion and auscultation

Inspection :

• Examining the secondary sexual organ development
• Phallus ( part covering the urethra) : size and shape , foreskin arrangement , any ulcers
• Testicles : Any skin changes , swellings , lumps
• Prostate : inspect size , consistency , any swellings
• Inspect urethral opening for any discharges

Palpation :

• Through bimanual examination of abdomen by lifting the hand posteriorly under abdomen at kidney , palpate for any bulge , abnormal mass and for any hernias
• Palpate testis ; absence of testis suggests undescend testis ,small and firm testis suggests hypogonadism and atrophy .
• Palpate testicles and prostate for any tenderness and mass

Percussion :

• Percussion of abdomin for ascitis and for an enlarged bladder

Auscultation of renal bruit in renal artery stenosis

These are the above techniques to assess the genitourinary system of male

The usual abnormal finding of genitourinary system is Benign prostatic hypertrophy

Benign prostatic hypertrophy is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue .

It is usually diagnosed by history collection and physical examination .

Digital examination , urinalysis with culture if infection present .