NAMES OF MEMBERS

Chaole N 201802990 (Palpation of the inguinal lymph nodes & location of the femoral
pulse)
Motlapa N.G 20100518 (Palpation of the Penis and Prostate)
M0telle N 202100554 (Inspection of the male genitalia and Health Education)
Lishea E 202102778 (History taking and Palpation of the scrotum)
Group Assignment: Assessment of the male genitalia
Introduction
The male reproductive system mostly exists outside of the male body and external organs include
the penis and scrotum. Internal part of the male genitalia is composed of the testicles vas
deferens, prostate, epididymis, seminal vesicle and urethra. It is responsible for sexual function
and urination (Cleveland clinic, 2023).
History taking for physical assessment of male genitalia
1. Chief complaint
a. Ask the patient why they are seeking a genitalia assessment.
b. Encourage patient to describe their symptoms or concerns in the own words.
2. Present illness
a. Ask about the onset, duration and progression of symptoms.
b. Explore specific details about any pain, discomfort or changes in genitalia area.
c. Inquire about any discharge, bleeding or urinary symptoms, sores or swelling of
scrotum.
3. Sexual history
a. Discuss sexual function by asking patient about:
i. Relationship status.
ii. Sexual preference (whether they are straight or bisexual).
iii. How long does intercourse last?
iv. Sexual interest.
v. Achievement and maintenance of erection.
vi. Ability to reach orgasm as well as ejaculation patterns
vii. Any history of UTIs and STDS
History taking is a very important aspect of physical assessment because it is through it a health
personnel can be able to rule out anomalies or conditions. A few that can be found are:
 Retrograde ejaculation -this is whereby semen enters the bladder instead of coming
through the penis during orgasm, resulting in very little or no semen at all. It can cause
male infertility.
 Erectile dysfunction- difficulty in getting or keeping an erection
 Premature ejaculation-an ejaculation that occurs too early.
After collecting history, a healthcare professional moves on to examining the male genitalia
physically by using inspection and palpation techniques and he/she should examine the
following; penis, urethral meatus, scrotum, mons pubis as well as the testicles.
1. Inspection
a. Penis
i. Inspect the skin of the penis, prepuce (if present) and glans for color, it is
usually darker with a pinkish glans in normal cases.
 ii. Retract the foreskin to inspect for the presence of smegma (which is
normal body’s way of cleaning itself), secretions on the glans then replace
it.
iii. Note any ulcerations, scars, nodules, rash or visible signs of inflammation
on the skin of the penis.
iv. The position of the urethral meatus, it should be centered, normally.
v. Note the shape of the penis as well as the size (shape normally is
cylindrical).
vi. Compress the glans gently between your index finger and thumb to open
the urethral meatus and inspect for discharge.
vii. Distribution, quantity, texture and color of the pubic hair (should be black,
well distributed and coarse).
viii. Inspect for presence of any lice in the pubic hair as well as rash on mons
pubis.

b. Scrotum, testes and perineal area

i. Inspect for color, usually darker than the rest of the body skin and
wrinkled and striated.
ii. Note the symmetry, normally left half of the scrotum and testes are lower
than the right.
iii. Inspect the scrotum for swelling, scars, bruising and lesions.
iv. Note for the presence of scrotal septum
v. Inspect the perineal area, spread the buttocks wide apart with both hands
and observe the perineal region. The anus normally looks moist , hairless,
with coarse, folded skin that is more pigmented than the perineal skin. The
anal opening should be tightly closed.
2. Palpation
Penis
i. Palpate the shaft of the penis between your thumb and first two fingers
(index and middle fingers), for lumps, masses and nodules, normally feels
smooth, semi-firm and non-tender.
Scrotum and testes
ii. Palpate gently each scrotal half between your thumb and first two fingers,
the scrotal contents should slide easily.
iii. Palpate the testes, normally feel oval, firm and rubbery, smooth and
equally bilateral and are freely movable and slightly tender to moderate
pressure.
iv. Palpate for epididymis by gently rolling one testicle using the fingers and
thumbs of both hands. Feel along the underside of the scrotum to find the
 epididymis that sits at the back of the testicles. Normally feels like a bunch
of tightly curled tubes, discrete, softer, smooth and non-tender.
v. Palpate each spermatic cord between your thumb and fore finger along its
length from the epididymis up to the external inguinal ring. Feel smooth
and non-tender cord.
vi. Palpate the inguinal canal. For the right side ask the patient to shift his
weight on to the left leg. Place your right index finger low on the right
scrotal half so that you can carry as much skin as possible as you proceed.
vii. Palpate up the length of the spermatic cord. Invalidating the scrotal skin as
you go to the external inguinal ring. It feels like a triangular slit like
opening. If the positioned properly it will admit the finger, gently insert it
into the canal, and ask the patient to bear down. Normally feel no change.
Repeat the procedure on the left side
Palpate the anus and rectum
Drop the lubricating jell onto your gloved index finger. Instruction the patient that
Palpation is not painful but may feel discomfort and the need to move bowels. Ask the
patient to take deep breath and hold it. Place the pad of the index finger gently against the anal
verge. The sphincter will tighten and relax , then ask the patient to exhale, and flex the tip of the
finger and slowly insert it into the anal canal. Never approach the anus at right angles with the
index finger extended because it is painful. Rotate the examining finger to palpate the entire
muscular ring. The canal should feel smooth and even. To assess tone, ask the Patient to tighten
the muscle, the sphincter should tighten evenly around the finger with no pain to the patient.
 Palpate the prostate
o Palpation of the prostate involves inserting a lubricated gloved finger into the rectum
to feel for the size, shape and texture of the gland. The nurse carefully assesses for
tenderness, nodules, asymmetry or enlargement of the prostate, (Jarvis, C 2016).
Normally, the prostate is a walnut-sized organ, it has a conical or heart shape, with a
rounded apex and a broad base. In terms of texture, the normal prostate gland should
feel firm and smooth to touch, (Black JM, Hawks JH. 2016).
 Palpate inguinal lymph nodes
o Palpate the horizontal chain along the groin interior to the inguinal ligament and
the vertical chain along the upper inner thigh. It is normal to palpate an isolated
node on occasions it then feels small (<1cm) soft, discrete and movable.
 Locating for femoral pulse
o Place your right hand upright on the man’s right upper thigh. Locate the femoral
artery pulse with the index finger. Ask the patient to bear down and palpate the
femoral area for bulge. Do the same on the left side.
Documentation
Document the findings, an example may be;
Upon assessment, the color of penis is darker than the rest of the skin color with a pink glans.
The scrotum is also darker, wrinkled and striated, the left half of the scrotum and testes are lower
than the right. During palpation, the penis felt smooth, semi-firm and non-tender. The testes feel
oval, firm and rubbery, smooth and equally bilateral and are freely movable and slightly tender
to moderate pressure. The epididymis feels like a bunch of tightly curled tubes, discrete, softer,
smooth and non-tender. The spermatic cord feels smooth and non-tender. The prostate gland is
heart-shaped, firm and smooth to touch.

Health Education
Encourage pt to maintain good hygiene and care of their genitalia to reduce the chances of
developing problems like skin irritations and some common infections. When educating pt, the
following should be included;
 Patient should wash the genitalia on a daily basis, using water and soap, but not too much
of it as it may cause irritation. For those individuals who are uncircumcised, they should
retract prepuce to thoroughly clean the glans and wash out smegma as its accumulation
can cause genital odor and infections.
 Patient should wash their hands before touching their penis, it may be for instance when
urinating in a case where pt had been in contact with anything that may be an irritant such
as chilli pepper, chemicals etc.
 After urinating, advise patient to gently normalize shaking their penis to eliminate any
remaining drops of urine accompanied by wiping the area in order to prevent any
moisture as moisture promote rapid growth of some microbes.
 Encourage patient to wear loose underwears and boxers to avoid too much heat and
tension that can be brought by tight underwears, as too much heat and tension more
especially on the testicles tend to cause some complications including testicular torsion.
 Encourage patient to practice safe sex by using condoms to prevent contraction of STIs
from their partner(s).
 Advise patient to go for circumcision if they have not yet, as it reduces risk of contracting
STIs.
 Encourage patient to have regular exercises as physical exercises tend to reduce chances
of erectile dysfunction (ED).
 Patient should normalize eating balanced meals and those that include spinach and
avocados as they boost testosterone levels hence improving fertility.
 Patient should be encouraged to shave as pubic hair can cause warmth and moisture
which can result in increased infections.
 Patient should be encouraged to drink and smoke minimally as excessive alcohol
consumption and smoking can cause erectile dysfunction.
 Instruct patient to report or visit a health facility immediately when they experience
strange things in their genitalia such as swelling, persistent itchiness, rash, any
discharges, painful urination, any bleeding etc.
 REFERRENCES

Bickley L.S. (2013). Bate’s Pocket Guide To Physical Examination And History Taking.
“Male genitalia and hernias”. (7th Ed). Wolters Kluwer.
Black JM, Hawks JH. (2016). Medical-Surgical Nursing: Clinical Management for
Positive Outcomes (8th ed.). Saunders, (Print).
Busti J.A. (2016). Male Genitalia Exam. [Retrieved from https://www.ebmconsult.com].
[Accessed on November 1,2023].
DR. Elist. (2015). Genital Hygiene for males. [Retrieved from https://www.drelist.com].
[Accessed on November 19, 2023].
Healthdirect.(2021). Penis Care. [Retrieved from https://www.healthdirect.gov.au].
[Accessed on November 19, 2023].
Healthy male.(2022).Step by step guide to male genital examination. [Retrieved from
https://www.healthymale.org.au]. [Accessed on November 19, 2023].
Jarvis C. (2016). Physical Examination and Health Assessment (7th ed.). Saunders (Print).
Sampson S& Ferguson S. (2019). Everything you need to know about penis health.
[Retrieved from https://www.healthline.com]. [Accessed on November 19, 2023].