Examination of Male Genitalia
The examination of male genitalia involves a systematic assessment of the external and internal reproductive organs to identify any abnormalities, infections, or diseases. The examination is typically performed by a healthcare professional, such as a doctor or nurse practitioner, and may be part of a routine physical examination or a specific evaluation based on a patient’s concerns or symptoms.
Before beginning a detailed Examination Of The Male Genitalia, it is essential and most helpful to take a history of the patient regarding sexual function, sexual preferences, sexual responses and pain, swelling or lesions in the penis or scrotum, if any.
The examination is done with the patient standing or supine. When examining for varicoceles and hernia, the patient should be in the standing position. It is advisable to wear gloves throughout the examination.
Here are some synonyms for "examination of male genitalia" depending on the context:
Medical terms:
- Genital evaluation
- Genitourinary (GU) examination
- Testicular exam
Informal terms:
- Checking the manhood
- Examining the downstairs (avoid using this in a medical setting)
INSPECTION
PALPATION
AUSCULTATION
External Examination
Internal Examination
Other Tests
Important Considerations
Terminology
INSPECTION
INSPECTION:
EXAMINATION OF PENIS:
SKIN IN MALE GENITALIA
The skin of the penis should examine for the presence of moist excrescences (i.e. venereal warts), vesicles and/or shallow, painful ulcers with red base (in other words; genital herpes), dark red, painless, indurated ulcers (i.e. syphilitic chancre), non-tender hard plaques (i.e. Peyronie’s disease), displacement of urethral meatus to inferior surface (i.e. hypospadias) or non-tender, indurated, painless nodules/ulcers (in other words; carcinoma).
PREPUCE IN MALE GENITALIA
If the foreskin is present, it should retract during examination for detection of syphilitic chancres or carcinoma.
GLANS IN MALE GENITALIA
It should examine for any signs of inflammation, scars, nodules or ulcers.
Moreover; The skin around the base should examine for any excoriations which may suggest lice or scabies.
Besides this, Compressing the glans between the thumb and index finger opens the urethral meatus to examine for discharge, if any.
All in all, A white or clear discharge is suggestive of non-gonococcal urethritis, whereas an excessive yellow discharge seen in cases of gonococcal urethritis.
EXAMINATION OF SCROTUM & ITS CONTENTS:
The skin of the scrotum carefully examine, both anteriorly and posteriorly for rashes, epidermoid cysts and dermal cancer. The contours examine for lumps, veins or swellings. Common causes of swellings include hydrocele and indirect inguinal hernia. Swellings are tender and painful in cases of strangulated inguinal hernia, acute orchitis and torsion of spermatic cord.
EXAMINATION OF HERNIA:
The femoral and inguinal areas need to examine for presence of any bulges. The patient ask to either cough or strain down. If a bulge appears on straining, it is likely to be a hernia.
PALPATION
PALPATION:
PENIS:
During male genitalia examination, palpate along the entire shaft of the penis for signs of tenderness and induration. A urethral stricture or carcinoma of penis can present as induration of the ventral surface of the penis. In detail, The addition of tenderness may hint towards a periurethral inflammation coming on after urethral stricture.
SCROTUM & ITS CONTENTS:
Each testis and epididymis is palpated as to the size, shape and consistency, and tenderness, if any, also note.
The spermatic cord palpate between the thumb and fingers from epididymis to superficial inguinal ring and any swellings or nodules note. Numerous, tortuous veins may palpable (“bag of worms” sensation) indicating a varicocele; a thicken or bead vas deferens is suggestive of chronic infection, whereas a cystic swelling of the spermatic cord suggests a hydrocele of the cord.
Transillumination of the scrotum, done using the beam of a strong flashlight, after darkening the examination cubicle / room, is useful in clinically diagnosing abnormal swellings present in the scrotum. A red glow, from transmission of light through the swelling is seen in serous swellings like hydrocele, whereas in cases of tumors or hernia, transillumination is absent.
HERNIA:
INGUINAL
The loose scrotal skin invaginate with the index finger also the spermatic cord follow upto the opening of the external inguinal ring, just above also lateral to the pubic tubercle. In detail; If possible, the finger pass into the inguinal canal. If not, it kept fixed on the opening of the external inguinal ring also the patient now ask to cough or strain down. An inguinal hernia can felt by the finger using these maneuvers. Besides this; If the hernia touches the fingertip, it is indirect, also if it pushes the sides of the finger forward, it is a direct type of hernia.
FEMORAL
The femoral canal in the anterior thigh palpate also the patient ask to strain down or cough. An impulse feel to the palpating fingers in case a femoral hernia is present.
SCROTAL
A scrotal hernia may suspect if the scrotal mass is large. In such cases the patient ask to lie down. If the mass returns to the abdomen on lying down, it is definitely a hernia. On the other hand, If the mass does not reduce then ‘getting above the mass’ is attempted; if one cannot get above the mass, then the findings are suggestive of a scrotal hernia. If sustained pressure apply to reduce the hernia back into the abdomen, and the patient complains of tenderness, nausea or vomiting, hernial strangulation suspect.
AUSCULTATION
AUSCULTATION:
Examination of Scrotal Hernia:
The stethoscope use in male genital examination only when a scrotal hernia suspect, to listen for bowel sounds in the scrotum. Positive bowel sounds in the scrotal area are a definitive pointer towards herniation of intestines in the scrotum, although it is not necessary that bowel sounds may hear in all cases of scrotal hernia.
External Examination
External Examination:
- Inspection: The healthcare provider visually assesses the appearance of the penis, scrotum, and surrounding areas. This includes checking for any lesions, rashes, ulcers, swelling, discoloration, or discharge. The size and shape of the penis and scrotum are also noted.
- Palpation: The healthcare provider gently feels the penis, scrotum, and testicles to assess for any lumps, masses, tenderness, or irregularities. The epididymis (a coiled tube behind each testicle) is also examined for any abnormalities.
Internal Examination
Internal Examination:
- Digital Rectal Exam (DRE): The healthcare provider inserts a gloved and lubricated finger into the rectum to examine the prostate gland for any enlargement, nodules, or tenderness. This examination is typically performed in men over 50 or those with specific risk factors for prostate problems.
Other Tests
Other Tests in Examination of Male Genitalia
Depending on the patient’s history and symptoms, additional tests may be performed, such as:
- Urinalysis: To check for infections or other abnormalities in the urine.
- Blood tests: To assess for sexually transmitted infections (STIs) or other conditions.
- Imaging studies: Such as ultrasound or MRI, may be used to visualize the internal structures of the reproductive organs in more detail.
Important Considerations
Important Considerations in Examination of Male Genitalia:
- The examination of male genitalia is a sensitive procedure, and healthcare providers should ensure patient comfort and privacy.
- Patients should feel free to ask questions and discuss any concerns they may have with their healthcare provider.
- Early detection of any abnormalities is crucial for prompt diagnosis and treatment of any underlying conditions.
Disclaimer: This information is not intended as a substitute for professional medical advice. Always consult with a healthcare provider for any concerns or questions regarding your health.
Terminology
Terminology
External Genitalia:
This refers to the reproductive organs that are visible outside the body. These include:
- Penis: The male organ for sexual intercourse and urination.
- Scrotum: The pouch of skin that contains the testicles.
Internal Genitalia:
These are the reproductive organs located inside the body. They include:
- Testicles (Testes): The two male glands that produce sperm and testosterone.
- Epididymis: A coiled tube on top of each testicle where sperm mature.
- Vas Deferens: The ducts that carry sperm from the testicles to the urethra.
- Seminal Vesicles: Glands that produce fluid to nourish sperm.
- Prostate Gland: A gland that produces fluid to help sperm move.
- Bulbourethral Glands: Glands that produce fluid to lubricate the urethra.
Key Terms Used in Examination:
- Inspection: Visually examining the external genitalia for abnormalities.
- Palpation: Feeling the testicles and surrounding structures for lumps or tenderness.
- Transillumination: Shining a light through the scrotum to check for fluid or masses.
- Digital Rectal Exam (DRE): Inserting a gloved finger into the rectum to feel the prostate gland for abnormalities.
Specific Medical Terms:
- Hypospadias: A condition where the opening of the urethra is on the underside of the penis.
- Epispadias: A condition where the opening of the urethra is on the top of the penis.
- Phimosis: A condition where the foreskin cannot be retracted over the glans penis.
- Paraphimosis: A condition where the retracted foreskin cannot be pulled back over the glans penis.
- Hydrocele: A fluid-filled sac around a testicle.
- Varicocele: Enlarged veins in the scrotum.
- Testicular Torsion: Twisting of the spermatic cord, cutting off blood flow to the testicle.
- Inguinal Hernia: A bulge in the groin caused by a weakness in the abdominal wall.
Examination Procedure:
- Patient History: Gather information about any symptoms, medical history, and sexual activity.
- Physical Examination:
- Inspection: Look for any abnormalities in the size, shape, or color of the external genitalia.
- Palpation: Feel the testicles for lumps, tenderness, or changes in size.
- Transillumination (if needed): Check for fluid or masses in the scrotum.
- DRE (if indicated): Examine the prostate gland through the rectum.
Frequently Asked Questions (FAQ)
What is Examination Of The Male Genitalia?
Before beginning a detailed Examination Of The Male Genitalia, it is essential and most helpful to take a history of the patient regarding sexual function, sexual preferences, sexual responses and pain, swelling or lesions in the penis or scrotum, if any.
How can I prepare for a male genital examination?
There is no specific preparation required. It’s helpful to maintain good hygiene and wear loose-fitting underwear to the appointment.
What are the methods of Examination Of The Male Genitalia?
- Inspection
- Palpation
- Auscultation
What is examined in Examination Of The Male Genitalia?
- Penis
- Scrotum and its Contents
- Hernia
Are male genital examinations painful?
Generally, male genital examinations are not painful. However, if there is an underlying condition or infection, some discomfort may be experienced during palpation.
What is the purpose of a male genital examination?
Purpose
A male genital examination is conducted to assess the health of the penis, scrotum, testicles, and surrounding structures. It helps to identify any abnormalities, infections, or signs of underlying conditions.
When should a male have his genitalia examined?
It’s recommended for males to have their genitalia examined as part of a routine physical examination, especially if they experience any unusual symptoms such as pain, swelling, lumps, or changes in urination.
