Male Urogenital System - Genitalia Exam

Genitalia Examination

Penis

• Gloves on.
• Retract foreskin if indicated.
• Rashes, ulcerations, swellings, lesions, warts.
• Urethral meatus:
  • Meatus is patent
  • Meatus is in normal location.
  • No extra openings (hypospadias).
• Look for discharge:
  • Bloody.
  • Purulent.
  • Smegma [cheese-like substance] under foreskin.
• If discharge, compress penis to excrete some into jar for analysis.
• Tell pt. to cough (stress incontinence).

Scrotum: inspect

• Pt. standing up.
• Asymmetry is normal: L lower than R.
• Note size (mumps), position.
• Rashes, ulcerations, swellings, lesions.
• Look for discharge:
  • Bloody.
  • Purulent.
• Tell pt. to cough (stress incontinence).

Scrotum: palpate

• Similar size, consistency for R and L.
• Smoothness, firmness.
• Absent testicle causes:
  • Undescended [look in inguinal canal].
  • Surgical removal.
• Masses. See Testicular Masses ( find this in step 3 )
• If mass palpated, Dr tries to get above it. If unable, likely an inguinal hernia.

Scrotum: translucency

• Perform if a mass was palpated.
• Turn off lights.
• Hold light up to posterior of swelling, and test for translucency:
  • Opaque: solid mass.
  • Translucent: cystic.
• Examine whether separate from the testis.
• See Testicular Masses ( find in step 3 )

Spermatic cord

• Palpate from epididymis to superficial inguinal ring.
• Locate both R and L ductus deferens within scrotum.