You are seeing Bill Byrd, a 40 year old man in your outpatient clinic because he recently noticed a testicular mass. Perform a full genital examination.
Physical Examination
Scrotum
- Inspects scrotum for asymmetry and skin lesions
- Palpates testicles bilaterally
- Comments on masses: size, location, consistency, tenderness, irregular shape
- Palpates epididymis for tenderness, enlargement
Penis
- Inspects penis for erythema, swelling, deformity
- Palpates along penile shaft for irregularity
- Examines foreskin for signs of infection
- Exposes glans for inspection, and replaces the foreskin after completing the examination
- Examines meatus for discharge
Hernias
- Palpates inguinal region bilaterally for presence of hernias
- Assesses for hernias with patient standing up
- Asks patient to bear down during palpation of scrotum
Digital Rectal Examination
- States that a digital rectal examination would be performed as part of the genitourinary examination
Case 3 – Testicular Mass