External genitalia examination

The examination of the external genitalia can be carried out by a specialist, mainly including penis examination, urethral opening examination, and scrotal examination. People can also self-test to help detect certain diseases early. Pay attention to rest, add enough liquid, use separate thermometer to prevent indirect infection, and disinfect bathroom, towel and bed sheets. In order to prevent infection, sexual partners should avoid sexual life before they are completely cured. The towels, washbasins, sheets and other infectious materials should be used strictly; the pollutants can be boiled and disinfected. Basic Information Specialist classification: eugenics and superiority examination classification: other inspection Applicable gender: whether men and women apply fasting: not fasting Tips: pay attention to rest, add enough liquid, to prevent indirect infection should be used separately, the bathroom, towels and sheets should be disinfected. Normal value 1. The penis is divided into roots, bodies and heads. It consists of two corpus cavernosums on the dorsal side and one urethral cavernous body on the ventral side. The corpus cavernosum is a round blunt body with pointed ends, and the corpus cavernosum on both sides is The pubic symphysis begins to merge into one. The urethral cavernous body is slender and round and blunt. The front end is called the glans, and the cap is placed at the tip of the two corpus cavernosum. 2, normal urethral mucosa rosy, clean, no secretions. Gram staining of urethral secretions showed an average of <5 per field of view under oil mirror (1000 times), and no hemorrhage and bloody secretion of <15 polymorphonuclear leukocytes per field of view in high magnification (400 times) field of view. Substance, purulent secretions, liquid secretions, etc. Clinical significance Abnormal result 1. The corpus cavernosum angiography shows that the penis foot and the lower part of the ischial bone are "separated" on the X-ray, and the development of the penile vein system is observed. If the penile vein is developed, there are common penile venous leaks, penile foot leaks, cavernous septal leaks, ectopic venous leaks, spongiforms, and mixed types. 2. Penile artery blood pressure When the penile artery blood pressure is lower than the systemic mean arterial blood pressure by 30 mmHg (4.0 kPa), or the penile artery index is lower than 0.6 is abnormal. The measurement of penile artery blood pressure is often not constant, which is due to both technical limitations and the effects of penile vascular response on the environment and mood. Therefore, if an abnormal result is measured, it is necessary to repeatedly measure and verify that the penile artery index abnormality may be made. Penile artery blood pressure measurement may be helpful in diagnosing arterial insufficiency, but it is not very reliable to use this test to exclude arterial insufficiency as the cause of impotence. Moreover, it does not clarify any condition of blood flow, and it is even less able to detect penile artery function in an erect state. 3, foreskin phimosis inspection If the phimosis or foreskin is too long, it may be because the foreskin is long wrapped in the glans, the temperature and humidity inside the foreskin is increased, easy to grow and breed bacteria and inflammation, for a long time, can form foreskin and glans adhesion, can cause pain in sexual intercourse . In addition, the smegma secreted by the foreskin sebaceous glands has a penile cancer effect. 4, male urethral secretion Gram stain smear examination showed polymorphonuclear leukocytes, under the oil microscope (1000 times), the average per field ≥ 5 were positive. In the morning, the first urine or urination interval of 3 to 4 hours of urine (15 ml of anterior urine) sediment in the high power microscope (400 times) field of view, the average per field of ≥ 15 polymorphonuclear leukocytes have diagnostic significance. Or male patients <60 years old, no kidney disease or bladder infection, no prostatitis or mechanical damage to the urinary tract, but those with positive urine white cell esterase test can also be diagnosed as non-gonococcal urethritis. Female cervical mucus purulent secretion, yellow, with an average of 10 lesions per field of polymorphonuclear leukocytes under oil mirror (1000 times) (but should be excluded from trichomoniasis). 5, such as urethral red mouth swelling, attached secretions or ulcers, and tenderness, more common in urethritis caused by gonococcal or other pathogen infection; urethral stricture caused by congenital malformation or inflammation adhesion; urethra is located The ventral surface of the penis is mostly caused by hypospadias. Patients who need to be examined for impotence, abnormal penile function, urgency, dysuria, and non-gonococcal urethritis. Precautions Contraindications before examination: pay attention to rest, add enough liquid, to prevent indirect infection should be used separately, the bathroom, towels and sheets should be disinfected. In order to prevent infection, sexual partners should avoid sexual life before they are completely cured. The towels, washbasins, sheets and other infectious materials should be used strictly; the pollutants can be boiled and disinfected. Personal prevention of available condoms. Requirements for inspection: 1. Keep your hands clean during self-examination. Keep your penis, urethra and scrotum checked. 2, if the penis, scrotum, epididymis, spermatic cord examination during self-examination, do not panic when there is pain and lumps or nodules, you should go to the regular hospital for detailed examination in time, so that early detection and early treatment. Inspection process Self-inspection mainly includes the following five aspects. (1) Pay attention to the distribution of pubic hair, whether there is external genital malformation (such as hypospadias, cryptorchidism, etc.). If there is deformity, further check the body posture, hair distribution, and mammary gland development. (2) The development of the penis, such as whether the foreskin is too long, whether there is phimosis or incarceration, whether the development of the penis is consistent with age, whether there is ectopic urethral opening (upper or lower urethra), inflammation of the urethra, Adhesion, stenosis or cyst. (3) Whether there is tenderness or induration in the case of the corpus cavernosum, and there are no lesions such as papules, sputum or ulcers in the head of the penis, and there are no inflammation, scars or new organisms. (4) Scrotal contents examination First pay attention to the size and shape of the scrotum, whether there is chronic fistula or skin adhesion, if there is swelling of the scrotum, is it on one side or both sides, and there is no acute inflammation change in the scrotal skin. For a scrotal mass, it should first be clear from the scrotum or from the abdominal cavity. Can be distinguished by standing and supine position examination, such as scrotal mass inguinal hernia, traffic hydrocele or varicocele, often disappear or shrink when lying down, press the inguinal canal with your fingers while standing In the outer ring, the mass no longer appears. After the finger is removed, the mass is lowered into the scrotum. Secondly, the hardness of the palpable mass, whether there is a sense of fluctuation or firmness, palpation of the inguinal outer ring with or without cough impact and recovery . Carefully distinguish the relationship between the scrotum mass and the testis, epididymis and spermatic cord. The light transmission test should be routinely performed, and the testicular hydrocele test is positive, but if the sheath is thickened or the effusion is turbid, it cannot be transmitted. In cases of scrotal trauma, the mass in the scrotum is often hydrocele, the swelling of the mass is large, the skin of the scrotum is freckled, and the light transmission test is negative. Testicular examination should pay attention to its size, shape, hardness, weight, and whether there is any abnormality. The early testicular tumor still looks like a testis. It continues to develop a tumor with a rounded volume, a smooth surface and a hard surface. The testicles have a heavy feeling and the light transmission test is negative. This is a testicular tumor. If the medical history and physical signs are consistent with the tumor, attention should be paid to whether there is a lump in the abdomen and whether there is any metastasis adjacent to the abdominal aorta. Epididymal examination should pay attention to determine the location of the lesion, the size of the epididymis head, body, tail, hardness, presence or absence of nodules and tenderness, with or without abscess or scrotal fistula, vas deferens with or without thickening or nodules. The spermatic cord examination pays attention to whether there is a lump in the spermatic cord and whether there is varicocele. Pay attention to the thickness of the vas deferens, with no nodules or tenderness, to rule out chronic inflammation or tuberculosis of the vas deferens. The spermatic cord tumor is more common, mostly benign, such as lipoma, malignant spermatic cord tumor is mostly sarcoma, can touch the hard mass in the scrotum. (5) Inguinal lymph node size, hardness and activity, with or without chronic ulcers or scars. Penis check: Use the thumb and forefinger to separate the urethral opening during the examination. 1, laboratory urethral secretion examination Smear, culture examination, evidence of no Neisseria gonorrhoeae. Male urethral secretion Gram staining smear showed polymorphonuclear leukocytes, and ≥5 per field was positive under oil mirror (1000 times). In the morning, the first urine or urination interval of 3 to 4 hours of urine (15 ml of anterior urine) sediment in the high power microscope (400 times) field of view, the average per field of ≥ 15 polymorphonuclear leukocytes have diagnostic significance. Or male patients <60 years old, no kidney disease or bladder infection, no prostatitis or mechanical damage to the urinary tract, but those with positive urine white cell esterase test can also be diagnosed as non-gonococcal urethritis. Female cervical mucus purulent secretion, yellow, with an average of 10 lesions per field of polymorphonuclear leukocytes under oil mirror (1000 times) (but should be excluded from trichomoniasis). At present, due to the unconditional or insufficient standardization of the culture and diagnostic kit for Chlamydia, it is only necessary to see inflammatory cells (polymorphonuclear leukocytes) in the clinical laboratory diagnosis and to eliminate the gonococcal infection to make a diagnosis. 2, through the urethral secretions to check the types of urethral secretions are: 1, urethral bleeding Urethral bleeding refers to the involuntary overflow of blood from the urethra, and has nothing to do with urination. It can be seen that there is fresh blood spilling or dripping from the urethral opening, or there is blood in the mouth of the ten urethra. Urethral hemorrhage is often caused by urethral injury or urethral instrument application causing rupture of the urethral vascular rupture. Or found in urethra stones, urethral foreign bodies, urethral tumors, urethritis, prostatitis and urethral ulcers. 2, urethral blood secretions The urethral bloody secretion refers to the secretion of pus and blood in the urethral orifice or the secretion of blood and mucus. Urethral bloody secretions are mostly caused by urinary tract infections. More common in urethral injury, urethral stones, foreign body secondary infection, urethral tumor, urethral meat and urethritis, prostatitis, urethral obstruction such as stenosis, diverticulum, valve and so on. 3, urethral purulent secretions There is a yellow viscous secretion in the urethral opening. There are a large number of pus cells in the microscopic examination, or there is a purulent adhesion in the urethral orifice, which is called purulent discharge of the urethra. The purulent discharge of the urethra is caused by a purulent infection of the urethra. More common in prostatitis, tuberculous urethritis, gonorrhea urethritis, as well as urethral stones, foreign bodies, tumors, injuries, stenosis, diverticulum, valves and other secondary infections or indwelling catheters in the urethra, the use of equipment, the use of chemicals, another There are masturbation and so on. 4, urethral mucus secretions The urethral orifice has mucous secretions or mucus sputum attached to the urethral mucus secretion. Its performance can be turbid, milky and viscous or clear and thin. Urethral mucus secretions are more common in non-specific urethritis, fungal urethritis, chlamydia, mycoplasma, gonorrhea, trichomoniasis or virus-induced urethritis, prostatitis, prostate leakage, urethral bulbitis. Not suitable for the crowd Allergic to vasoactive substances (prostaglandin E1), patients with sickle cell anemia, multiple myeloma, leukemia and easy to induce abnormal erection, patients with penile cavernous fibrosis, penile prosthesis, severe cardiovascular disease, severe People with heart rhythm disorder, hypotension, and old age should be banned or used with caution. Adverse reactions and risks No complications.

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