Male Exam

Question 1

When should a male genital exam be performed

Answer 1

• as indicated by presenting complain/symptoms
• PMH (germ cell tumors, cryptochidism)
• family history of testicular cancer
• specific need

Question 2

what is associated with cryptorchidism 7-10% of the time

Answer 2

testicular cancer

Question 3

when does the GU exam come?

Answer 3

at the end of head to toe physical

Question 4

what is the order of the male genital exam?

Answer 4

1. Inguinal/pubic region
2. Hernia check
3. Penis/glans
4. Scrotum (sac, testes, epididymis, spermatic cord/vas deferens)
5. Rectal/prostate
6. Breast (as needed, based on history)

Question 5

where is a impulse felt for indirect or direct inguinal hernia?

Answer 5

• A impulse felt at the tip of the finger indicates an indirect inguinal hernia
• Impulse at the side of the finger is indicative of a direct inguinal hernia

Question 6

if a scrotal mass is present what should you use?

Answer 6

trans-illumination may be performed to assist in

diagnosis (hydrocele vs hernia vs solid mass)

Question 7

when should you do a rectal and prostate exam?

Answer 7

• Blood in stool, chronic constipation, pain with defecation, symptoms of prostate
inflammation/infection/enlargement
• Over 50 yo and the patient chooses to have a prostate exam/PSA blood test

Question 8

what is the position for a prostate/rectal exam?

Answer 8

• Patient is usually facing away from you, leaning forward, elbows on exam table (can use
lateral decubitus position)

Question 9

hydrocele

Answer 9

• accumulation of fluid around a testicle
• painless scrotal swelling
• usually diagnosed at birth and resolves within year
• can develop in adulthood (primary and secondary)
• transilluminate
• scrotal ultrasound
• testicle within swelling

Question 10

indirect inguinal hernia vs direct

Answer 10

indirect goes through the deep inguinal ring

Question 11

why should inguinal hernias be treated?

Answer 11

risk of strangulation

Question 12

testicular torsion

Answer 12

• Testicular torsion is an emergency condition. It happens when the
spermatic cord, which provides blood flow to the testicle, rotates and
becomes twisted. The twisting cuts off the testicle’s blood supply and
causes sudden INTENSE pain and swelling.
• CALL THE SURGEON

Question 13

testicular cancer

Answer 13

• lump or enlargement in testicle
• heaviness in scrotum
• dull ache in abdomen or groin
• sudden collection of fluid in scrotum
• pain or discomfort in testicle or scrotum
• enlargement/tenderness of breast
• back pain