Examination of Male Genitalia

Question 1

How should the patient be positioned?

Answer 1

Supine (lying down)

Standing at the end for the cough

Question 2

What is your initial inspection?

Answer 2

Pubic hair distribution

Scrotal skin for rashes or nodules

Scrotal contours for obvious swelling, scars or veins (varicocele)

Inspect the urethral meatus and note the presence or absence of foreskin. Size and position of urethral meatus.

Foreskin pathology (phimosis/paraphimosis)

Glans: Inflammation (balanitis), warts, ulcers or tumours (which usually present as a discrete, irregular red lesion)

Hair, rash, no

Swell, scar, ve

Foremeat, glans, IWUT

Question 3

What is involved in the palpation?

Answer 3

Any pain?

Examine testis:

• Size, consistency and texture

Examine epididymis

• Nodules, swelling or added tenderness

Spermatic cord

• To the level of the superficial inguinal ring, if possible assess for the presence of varicocele

Testicular Swellings

• Is swelling seperate?
• Can you get above the swelling?
• Swelling reducible?
• Cough impulse?
• Swelling fluctuant/solid?
• Transilluminate?

Examination of hernial orifices