Nurs 5432 module 4: men's health and
STDs\\NURS 5432 Module 4: Men’s Health &
STDs – 2025 Complete Study Guide
cryptorchidism
undescended testicles
Cryptorchidism treatment
orchiopexy typically at ages 6-18m
cryptorchidism risks later in life
testicular cancer
epididymitis
inflammation oftheepididymis that is frequently caused bythespread of infection fromtheurethra
orthebladder
Epididymitis S/S
o pain
o dysuria
o urgency/frequency
o low back pain/perineal pain
o fever/chills/malaise
o scrotal edema!!
Epididymitis treatment for sexually active men under age 35
doxy 100mg BID x 10 days AND ceftriaxone 500mg IM once
epididymitis treatment for men over age 35 and you do not suspect STD
Levfloxacin 500mg PO daily x 10 days OR Ofloxacin 300mg BID X 10 days
Epididymitis treatment for men who have sex with men
think they need to cover gram negative bacteria... e. coli lives inthecolon so that isthelikely cause.
Ceftriaxone 500mg IM once AND Levofloxacin 500mg PO daily x 10 days
Epididymitis PE
Prehn's sign is positive
normal cremasteric reflex
,possible urethral discharge
enlarged and tender epididymis
epididymitis diagnosis
Ultrasound: shows enlarged epidydimis and increased testicular blood flow
STD testing
US if they have pyuria and/or hematuria
elevated CBC
CRP and sed rate will be elevated
hydrocele
scrotal swelling caused by a collection of fluid
are hydroceles in infants communicating or non-communicating?
communicating
are hydroceles in adults communicating or non-communicating?
non-communicating
what istheconnection between testicular cancer and hydrocele
10% of testicular malignancies present with a hydrocele
hydrocele assessment
PAINLESS swelling
o Scrotum size will fluctuate with communicating hydrocele... becausetheopening is not closed...the
fluid has somewhere to go
o Scrotum feels heavy, especially after coughing, crying, and raising arms
o Noncommunicating hydroceles do NOT change shape with crying or straining
o Scrotum will transilluminate with both communicating and non-communicating
Hydrocele diagnostics
none needed, but you have to do an ultrasound to rule out a tumor!
Hydrocele management
The majority of infants born with hydroceles will have spontaneous resolution bythetime they are 1 year
old; thus reassurance and observation arethemost appropriate forms of management.
sx only if persist for >1 year
spermatocele
· Benign, cystic scrotal mass along spermatic cord, usually at head of epididymis. Measures over 2cm and
may contain non-viable sperm
spermatocele assessment
, o Palpable, painless, freely moveable cystic mass distinct from testis (pretesticular lesion)
o Intratesticular lesions always require further workup
o Size 2-5cm
o Usually asymptomatic
o Always located superior to testicle...hydrocele isn't. this is something that separatesthe2 diagnosis
Spermatocele management
none needed unless it is painful
aspiration will show non-viable sperm
does not affect fertility
varicocele
enlarged veins ofthespermatic cord
Varicocele grading
grade 1: only palpable with valsalva maneuver
grade 2: cant see it, but can feel it when they stand
grade 3: clearly visible
varicocele assessment
usually asymptomatic, they come in for fertility issues normally
do a doppler US, IV pyelography to r/o renal tumor or venous obstruction
Varicocele management
grade 1: reassure
grade 2-3 and there is <20% size difference in testicles: reassure and refer to urology if they desire
fertility
grade 2-3 and there is >20% size difference inthetesticles: refer to urology
scrotal support
NSAIDS
semen analysis q2 years
Testicular Torsion
· Urologic emergency that occurs whenthespermatic cord twists and causes constriction ofthevascular
supply tothetesticle
testicular torsion s/s
most commonly 10-20 year olds
ACUTE onset of severe testicular pain
does not have any voiding symptoms
pain is made WORSE by prehn's sign
no cresmeteric reflex noted
affected testicle will have a 'high lie"
STDs\\NURS 5432 Module 4: Men’s Health &
STDs – 2025 Complete Study Guide
cryptorchidism
undescended testicles
Cryptorchidism treatment
orchiopexy typically at ages 6-18m
cryptorchidism risks later in life
testicular cancer
epididymitis
inflammation oftheepididymis that is frequently caused bythespread of infection fromtheurethra
orthebladder
Epididymitis S/S
o pain
o dysuria
o urgency/frequency
o low back pain/perineal pain
o fever/chills/malaise
o scrotal edema!!
Epididymitis treatment for sexually active men under age 35
doxy 100mg BID x 10 days AND ceftriaxone 500mg IM once
epididymitis treatment for men over age 35 and you do not suspect STD
Levfloxacin 500mg PO daily x 10 days OR Ofloxacin 300mg BID X 10 days
Epididymitis treatment for men who have sex with men
think they need to cover gram negative bacteria... e. coli lives inthecolon so that isthelikely cause.
Ceftriaxone 500mg IM once AND Levofloxacin 500mg PO daily x 10 days
Epididymitis PE
Prehn's sign is positive
normal cremasteric reflex
,possible urethral discharge
enlarged and tender epididymis
epididymitis diagnosis
Ultrasound: shows enlarged epidydimis and increased testicular blood flow
STD testing
US if they have pyuria and/or hematuria
elevated CBC
CRP and sed rate will be elevated
hydrocele
scrotal swelling caused by a collection of fluid
are hydroceles in infants communicating or non-communicating?
communicating
are hydroceles in adults communicating or non-communicating?
non-communicating
what istheconnection between testicular cancer and hydrocele
10% of testicular malignancies present with a hydrocele
hydrocele assessment
PAINLESS swelling
o Scrotum size will fluctuate with communicating hydrocele... becausetheopening is not closed...the
fluid has somewhere to go
o Scrotum feels heavy, especially after coughing, crying, and raising arms
o Noncommunicating hydroceles do NOT change shape with crying or straining
o Scrotum will transilluminate with both communicating and non-communicating
Hydrocele diagnostics
none needed, but you have to do an ultrasound to rule out a tumor!
Hydrocele management
The majority of infants born with hydroceles will have spontaneous resolution bythetime they are 1 year
old; thus reassurance and observation arethemost appropriate forms of management.
sx only if persist for >1 year
spermatocele
· Benign, cystic scrotal mass along spermatic cord, usually at head of epididymis. Measures over 2cm and
may contain non-viable sperm
spermatocele assessment
, o Palpable, painless, freely moveable cystic mass distinct from testis (pretesticular lesion)
o Intratesticular lesions always require further workup
o Size 2-5cm
o Usually asymptomatic
o Always located superior to testicle...hydrocele isn't. this is something that separatesthe2 diagnosis
Spermatocele management
none needed unless it is painful
aspiration will show non-viable sperm
does not affect fertility
varicocele
enlarged veins ofthespermatic cord
Varicocele grading
grade 1: only palpable with valsalva maneuver
grade 2: cant see it, but can feel it when they stand
grade 3: clearly visible
varicocele assessment
usually asymptomatic, they come in for fertility issues normally
do a doppler US, IV pyelography to r/o renal tumor or venous obstruction
Varicocele management
grade 1: reassure
grade 2-3 and there is <20% size difference in testicles: reassure and refer to urology if they desire
fertility
grade 2-3 and there is >20% size difference inthetesticles: refer to urology
scrotal support
NSAIDS
semen analysis q2 years
Testicular Torsion
· Urologic emergency that occurs whenthespermatic cord twists and causes constriction ofthevascular
supply tothetesticle
testicular torsion s/s
most commonly 10-20 year olds
ACUTE onset of severe testicular pain
does not have any voiding symptoms
pain is made WORSE by prehn's sign
no cresmeteric reflex noted
affected testicle will have a 'high lie"
