Male Genitals and Inguinal Area

the

external genitals,
the presence of any hernias,
prostate gland.

Equipment

Clean gloves

 Examination

of the male genitals by a female

practitioner
Examination

practitioner

of the female genitals by a male

Health History
Frequency

of digital rectal examinations

Frequency of testicular self-examination
Use of contraceptives
Occupational exposure to chemicals (tire and rubber
manufacturing, farming, mechanics)
History of sexually transmitted infection
History of discharge from the penis

 Difficulty

with urination (incontinence, hesitancy,

frequency, voiding at night)
History of erectile dysfunction
family history of nephritis,
Malignancy of the prostate, or malignancy of the
kidney.

 introduce

self
verify the clients identity
Explain to the client
Perform hand hygiene,
apply gloves
Provide for client privacy.
Request the presence of another person
Cover the pelvic area with a sheet or drape at all times when
not actually being examined.

once a month.
A convenient time is after a warm bath or shower
the normal testicle is smooth and uniform in consistency.
(A) roll the testis gently in a horizontal plane between the thumb
and fingers, feeling for any evidence of a small lump or
abnormality.
(B) Follow the same procedure for palpation in anvertical plane.
(C) Locate the epididymis
Repeat the examination for the other testis;
it is normal to find one testis larger than the other.

Techniques
Inspection
palpation

INSPECTION

The external genitalia are inspected for

size,
placement,
contour,
appearance of the skin,
redness,
edema, and
discharge.

Pubic Hair
Inspect the distribution, amount, and characteristics
of pubic hair.
Triangular

distribution, often spreading up the

abdomen
Scant

amount or absence of hair

Penis
Inspect the penile shaft and glans penis for
lesions, nodules, swellings, and inflammation.

NORMAL FINDINGS-PENIS
Penile skin intact
Appears slightly wrinkled and
varies in color as widely as other body skin
Foreskin easily retractable from the glans penis
Small amount of thick white smegma between the
glans and foreskin

Deviations from normal

Presence of lesions, nodules, swellings, or
inflammation
Foreskin not retractable
Large amount, discolored, or malodorous
substance

 Penis
Inspect

the urethral meatus for swelling,

inflammation, and discharge.
The urinary meatus is normally located in the
center of the glans penis
Pink

appearance
Positioned at the tip of the penis

Deviations from normal

Inflammation;
Discharge on the underside of the penile shaft, and
epispadias, on the upper side of the penile shaft

Scrotum
Inspect the scrotum for appearance, general size,
and symmetry.
Inspect all skin surfaces by spreading the rugated
surface skin and
lifting the scrotum as needed to observe posterior
surfaces.

Scrotum-normal findings
Scrotal skin is darker in color than that of the rest of
the body and is loose
Size varies with temperature changes (the muscles
contract when the area is cold and relax when the area
is warm)
Scrotum appears asymmetric (left testis is usually
lower than right testis)

Deviations from normal

Discolorations;
any tightening of skin (may indicate edema or
mass)
Marked asymmetry in size

Inguinal Area
Inspect both inguinal areas for bulges while the
client is standing, if possible.
First, have the client remain at rest.
Next, have the client hold his breath and strain or
bear down
No swelling or bulges
Swelling or bulge (possible inguinal or femoral
hernia)

PALPATION

Palpate any lesions, nodules, masses, tenderness,

contour, size
Palpate shaft of the penis
Each testis
Epididymis
Spermatic cord

Abnormal findings
lesions,
redness,
edema,
pain,
discharge,
fluid-filled

masses in the scrotum (hydrocele or varicocele),

and
displacement of the urinary meatus or
difficulties with voiding.

Normal Age-Related Variations

INFANT/CHILD
Development of pubic hair and
enlargement of the scrotum, testes, and penis
occurs at puberty
Spontaneous nocturnal emission of seminal fluid
occurs at puberty.

 The

foreskin of the uncircumcised infant is

normally tight at birth and should not be retracted.
It will gradually loosen as the baby grows and is
usually fully retractable by 2 to 3 years of age.
Palpate

the scrotum to determine if the testes are

descended; -may retract into the inguinal canal

 parent

or guardians approval
tell the child what you are going to do.
Preschool children are taught to not allow others to
touch their private parts.

OLDER ADULT
Decreased penis size
Decreased pubic hair
Decreased size and firmness of testes
Urinary frequency, nocturia, dribbling, and
problems with beginning and ending the stream
(prostatic enlargement)