Male GU Exam Flashcards
Male GU Health History Qs - Sexual Dysfunction
● “How do you feel about your ability to perform
sexually?” (ED, libido)
● “Does your partner have any concerns regarding your
sexual performance?” (relationship issues, stress)
● “Can you achieve and maintain an erection?” (ED)
● “Do you wake in the night or morning with erections?”
(would imply physiology is at least working some)
● “Do you climax too soon?” (Premature Ejaculation)
Male GU Health History - STIs
● “Do you have any penile discharge, dripping, or
staining of underwear?”
● “Do you have any sores or growths on the penis?”
● “Are you sexually active and, if so, do you have more
than one partner?”
● “Do you use barrier devices during sex?”
● “Do you have any concerns of HIV or other STIs ?”
● “Do you have sex with men, women, or both?”
Male GU Health History - Penile disorders
● “Do you have any abnormal curvature of the penis when it is erect?”
Male GU Health History - Scrotal/Testicular disorders
● “Do you have any scrotal/testicular pain?”
● “Do you have any scrotal swelling?”
● “Do you perform self-testicular exams?”
Male GU Health History - Prostate disorders (hesitancy, flow, frequency)
● “Do you have difficulty initiating urination?” “Is the flow weak?”
● “How often are you getting up in the middle of the night to pee?”
● “Do you feel you do not completely empty your bladder?”
A good genital examination can be done with patient
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standing. You should sit on a chair/stool in the front of the patient
Penile Shaft Exam - Inspection
● Lesions (warts, ulcers)
● Carcinoma (rare, usually poor hygiene,
uncircumcised)
● Evaluate the base of the penis for
excoriations, nits, or lice in the pubic hair
Penile Shaft Exam - palpation
● Palpate the shaft of the penis between
your thumb and first two fingers
● Note any induration or tenderness
● Plaques of Peyronie’s are usually palpable
Prepuce (Foreskin) Examination - retraction of foreskin
● If present, retract the foreskin
○ Phimosis (A) – Foreskin cannot be retracted over the glans
○ Paraphimosis (B)– Retracted foreskin cannot be returned
Prepuce (Foreskin) Examination - inspection
● Ulcerations, warts, carcinomas, or other skin lesions
● Smegma – cheesy white material, may accumulate
normally under the foreskin (skin and sebum)
● Candida is more attached, with underlying erythema
Glans Examination - Inspection
● Look for warts, ulcers, scars, nodules, or
balanitis (inflammation)
● Note the location of the urethral meatus
(hypospadias)
Glans Examination - palpation
● Compress the glans gently between your index finger above and your thumb below. This
maneuver should open the urethral meatus and allow you to inspect for discharge. Normally
there is none. Glans should be soft. In balanitis, will beindurated and/or tender
● If the patient reports discharge and you don’t see any: ask him (or do it yourself) to milk the
shaft of the penis from its base to the glans. This will bring some discharge out of the
urethral meatus for examination. Have a glass slide and culture materials close.
Scrotal Examination - Inspection
● Skin
○ Lift up the scrotum so you can see the
posterior surface. Why??
○ Look for rashes, warts, epidermoid
cysts, rarely skin cancer here
● Scrotal contours
○ Swelling, lumps, veins, symmetry
A poorly developed scrotum may suggest
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cryptorchidism (undescended testicle)
Scrotal Examination - Palpation
● Palpate each testis and epididymis between your thumb and first two fingers
● Locate the epididymis on the superior posterior surface of
each testicle. (It feels nodular and cordlike)
○ Enlargement of head-epididymal cysts/spermatocele
○ Enlargement of tail-epididymitis
● Note size, contour, and tenderness
● Palpate for nodules – testicle
● Check for cremasteric reflex
