Physical Exam: Male Reproductive System

I. History: Sexual history, sexually transmitted disease, contraception, surgery, associated urinary problems

• External genitalia
• Hair distribution: varies; hair extends from base of penis over symphysis pubis; coarse and curly
• Penis shaft, corona, prepuce, glans
• Urethral meatus is slit like opening positioned on ventral surface, millimeters from tip of glans; opening should be glistening and pink
• Scrotum:

1. skin more darkly pigmented; more wrinkled; usually loose
2. symmetry - left testicle is lower than right
3. size - changes with temperature

• Inguinal canal: no finding - no bulging

II. Palpation

•  Penis:

1. foreskin should retract easily
2. small amount of thick white secretion between glans and foreskin is normal
3. testicle - ovoid; ranges from 2-4 cm in diameter, smooth and rubbery; nontender

• Inguinal canal: Normal finding - inguinal lymph nodes not palpable

III. Geriatric Alterations

• Increased bogginess of prostrate
• Testes softer

IV. Rectum and Anus

• Inspection of perianal areas

1. skin - smooth and uninterrupted
2. anal tissues - normally moist and hairless

• Digital palpation:

1. Anal sphincter - note tone
2. Rectal walls - smooth and even
3. Prostrate gland = Palpate through anterior rectal wall; Small walnut-sized, heart shaped structure; Ranges from 2.5 to 4 cm in diameter; Normal findings - firm, protrudes <1 cm into rectum

• Alterations:

1. fissures
2. fistulas
3. polyps
4. pain
5. hemorrhoids

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