Assessment of the

Male Reproductive
System
Group Members:
Sharelly Tzib
Miguel Lee
Raelle guy
Emma Garcia
Jessica Ke
Geovanna Gonzalez
Julianne Jones
Michelle Herrera
Neecee Humes
 At the end of this presentation students will be
able to:

01 02 03
DESCRIBE THE DESCRIBE SPECIAL
DEVELOP QUESTIONS CONSDIERATION IN
ANATOMY AND
TO BE USED WHEN ASSESSMENT TECHNIQUES
PHYSIOLOGY OF THE
COMPLETING THE AND FINDINGS OF THE MALE
MALE REPRODUCTIVE REPRODUCTIVE SYSTEM.
FOCUSED INTERVIEW.
SYSTEM.

04
DESCRIBE TECHNIQUES
REQUIRED FOR
ASSESSMENT OF THE MALE
REPRODUCTIVE SYSTEM.
05
DIFFERENTIATE NORMAL
FROM ABNORMAL FINDINGS
IN THE PHYSICAL
ASSESSMENT OF THE MALE
REPRODUCTIVE SYSTEM.
ANATOMY & PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM
The General functions of the male reproductive system are:

manufacturing and protecting male gametes called sperm for fertilization

transporting sperm to the female reproductive tract, where fertilization
can occur
regulating hormonal production and secretion of male sex hormones
providing sexual pleasure
Some of the male reproductive organs serve dual roles as part of the
reproductive system and the urinary system. As part of the urinary
system, the male genitals serve as a passageway for expelling urine.
 Only some of
the internal
structures are
EXTERNAL palpable. INTERNAL
GENITAL ORGANS GENITAL ORGANS

1. Penis 1. Testis
2. Scrotum 2. Epididymis
3. Vas Deferens
4. Urethra
5. Inguinal Area
The two external 6. Perianal area
organs, are easily 7. Accessory Glands
inspected and
a. Seminal Vesicle
palpated.
b. Prostate Glands
c. Bulbourethral Glands
 Is a sac of skin and superficial fascia that hangs outside the
abdominopelvic cavity at the root of the penis Scrotum
A midline septum divides the scrotum, providing a compartment for each
testis

Support and serve as a protective covering for the testes and helps regulate
their temperature.

By hanging outside the abdominopelvic cavity, the scrotum helps maintain

a lower temperature than the rest of the body , 34 °C (93.2 °F), which is
essential for proper sperm production (spermatogenesis).

Smooth muscle fibers, called the dartos muscle, in the subcutaneous tissue
contract to give the scrotum its wrinkled appearance. When these fibers
are relaxed, the scrotum is smooth.

The cremaster muscle, consists of skeletal muscle fibers that controls the
position of the scrotum and testes. When it is cold or a man is sexually
aroused, this muscle contracts to pull the testes closer to the body for
warmth.
 Penis
The penis is centrally located between the groin areas and lies in front of
the scrotum.

3 parts: a root, body (shaft), and glans penis.

During sexual arousal, the penis contracts and elongates as its vasculature
dilates and fills with blood, leading to erection for penetration during
intercourse. .

The major functions of the penis are urination and ejaculation of sperm
during sexual intercourse.
 Testes
The testes are vital male reproductive organs (size of a
plum) responsible for sperm production and testosterone
secretion.

The are enclosed by two tunics: the tunica vaginalis and

the tunica albuginea.

Within, septa divide it into 250 lobules housing

seminiferous tubules where sperm is produced and while
Leydig's cells produce testosterone.
 Male Duct System

The duct system plays a crucial role in the

transportation of sperm. The three structures
comprising the duct system are the epididymis, the
ductus deferens, and the urethra
Epidymis
The epididymis is positioned on top of and just posterior
to each testicle is a comma- or crescent-shaped
epididymis, which is palpable upon physical examination.

It consists of a head, body, and tail.

Once the immature sperm have been produced in the

testes, they are transported into the epididymis where
they mature and gain motility over a period of about 20
days.
 VAS DEFERENS
The vas deferens, ascends from te epididymis and expands to
form the ampulla before joining the seminal gland duct to create
the ejaculatory duct, which empties into the urethra via the
prostate.

During ejaculation, peristaltic waves in the smooth muscle of the

vas deferens rapidly move sperm forward into the urethra.

The major functions of the ductus deferens are serving as an

excretory duct in the transport of sperm and serving as a
reservoir for mature sperm.
URETHRA

The urethra is the terminal portion of the male duct system.

The urethra serves as a conduit for the transportation of both urine and semen to the outside of the body.

Its three regions are:

■ Prostatic urethra, the portion surrounded by the prostate

■ Intermediate part of the urethra (or membranous urethra) in the urogenital diaphragm
■ Spongy urethra, which runs through the penis and opens to the outside at the external urethral orifice
Accessory Glands
Glands that are important in the formation of semen and
secretes fluid that enters the urethra in the male
reproductive systems.

These glands are the :

Seminal vesicles

Prostate gland

Bulbourethral gland.
Seminal Vesicles
THE SEMEN PRODUCED BY THE SEMINAL VESICLES
ARE A THICK YELLOW FLUID THAT IS COMPOSED
OF HIGH CONCENTRATIONS OF FRUCTOSE,
AMINO ACIDS, PROSTAGLANDINS, ASCORBIC
ACID, AND FIBRINOGEN.

RESPONSIBLE FOR 60% OF THE

SEMEN THAT IS PRODUCED
PROSTATE GLAND
ONE THIRD OF THE TOTAL
SEMEN PRODUCTION OF
THE MALE REPRODUCTIVE
SYSTEM.

SECRETE ALKALINE
SECRETIONS INTO THE
URETHRA TO AID SPERM
TRANSPORT DURING
SEXUAL INTERCOURSE.

CAN BE PALPATED
THROUGH THE
FRONT WALL OF
THE RECTUM
USING THE RECTAL
EXAM TECHNIQUE.
 BULBOURETHRAL GLANDS
SECRETES A CLEAR MUCUS INTO THE URETHRA THAT LUBRICATES THE URETHRA
AND INCREASES ITS ALKALINE ENVIRONMENT JUST BEFORE EJACULATION.
 THE 2 INGUINAL REGIONS HOUSES
APPROXIMATELY 12-14 LYMPH
NODES AND ARE DIVIDED INTO
SUPERFICIAL AND DEEP GROUPS.
PERIANAL REGION
LASTLY, THE PERIANAL REGION IS CAUDAL TO THE
MUSCLES OF THE PELVIC FLOOR AND MEDIAL TO
THE THIGHS.
IT IS LOCATED BETWEEN THE ANUS AND THE BULB
OF THE PENIS. IT IS BEST VISUALIZED AS A
DIAMOND SHAPE IN THE LITHOTOMY POSITION
AND IT HELPS STRENGTHEN THE PELVIC FLOOR.

“The inguinal region, also known as the groin, THE INGUINAL CANALS ARE
ASSOCIATED WITH THE ABDOMINAL
is an anatomical space in the lower portion
MUSCLES AND REPRESENT A
of the anterior abdominal wall, located POTENTIAL WEAK LINK IN THE
superior to the thigh, lateral to the pubic ABDOMINOPELVIC WALL.
tubercle, and inferomedial to the anterior
superior iliac spine (ASIS).” (Loukopoulou,
2023)
It consists of Inguinal Lymph Nodes and
Inguinal Canals.

INGUINAL REGION
SPECIAL CONSIDERATIONS
 Special considerations
Health Promotion

Enhance reproductive health by decreasing the

occurrence of sexually transmitted diseases (STDs).

Specific goals for males involve implementing effective

screening and prevention measures for infectious
diseases like chlamydia, syphilis, and gonorrhea.

A key focus is on reducing HIV transmission rates and

preventing AIDS and HIV-related deaths.
 Special considerations: Lifespan
Infant and children

infants born with ambiguous external genital organs should have

surgery before the age of 1 to decrease risk of testicular cancer.
The penis may vary in size but averages about 2.5 cm (0.98 in.) in
length and is slender.
The foreskin may be somewhat tight and not retractable until 2
or 3 years of age.
The testes should be palpable and are about 2 cm (0.78 in.) in
diameter at birth.
Undescended testes, called cryptorchidism, is a common
finding, especially if the infant is preterm.
The testes should descend spontaneously within the first year of
life.
 Special considerations: Lifespan
Infant and children

Enlargement of the testes in adolescence indicate the presence

of a tumor.
Testes smaller than 1.5 to 2cm may indicate adrenal hyperplasia.
At the onset of adolescent, testosterone levels increase and the
male child begins to develop sexual characteristics.
precocious puberty is an endocrine disorder characterized by
the development of adult characteristics in males under the age
of 10.
sexual relations at an early stage increase the chances of human
papilloma virus and penile cancer. HPV vaccine is recommended
for children ages 11-12 years.
 Special considerations: Lifespan
Tanner’s stages for evaluating sexual
maturity.
stage 1: preadolescence: the testes, scrotum and
penis are identical to early childhood.
stage 2: enlargement of the scrotum, pubic hair is
slightly pigmented and usually at the base of the
penis.
stage 3: pubic hair is dark and around the penis.
The penis increases in length, testes enlarge and
scrotum descend.
stage 4: the testes and scrotum continue to
grow; scrotal skin darkens. hair extends no
further than inguinal fold.
stage 5: Adult stage, scrotum ample, reaching
nearly to bottom of scrotum. Hair spreads to
medial surface of thighs
 lifespan consideration
Older Adult

- Pubic hair becomes thinner and turns gray.

- The prostate gland grows larger.
- The size of the penis and testes may
decrease.
- The scrotum hangs lower.
- The testes feel softer when palpated.
- Sperm production reduces during middle
age.
-Testosterone levels decline, leading to a
decrease in sex drive.
 Psychosocial
Considerations
A man's perception of his penis size compared
to others can affect his self-image, with some
fearing they're "too small" to satisfy a partner.
Feeling tired, sad, or stressed can make
someone less interested in sex, no matter how
old they are.
Ending a relationship, whether through breakup,
divorce, or loss, can make it difficult to start
new ones.
Experiencing betrayal similarly affects one's
level of sexual desire.
 Cultural and Environmental
Considerations
Religious and cultural beliefs affect reproductive health and
sexuality, including preferences for a same-gender examiner.
Certain cultures and religions have different beliefs about
circumcision and sexual practices. For instance, religions like
Judaism and Islam require male circumcision. In many
cultures, it's seen as a way to promote hygiene.
Testicular cancer is most prevalent in males aged 20 to 34,
including adolescents, making monthly testicular self-
examinations essential.
For example, white males are more likely to get testicular
cancer.
 Gathering Data
THE ASSESSMENT OF THE MALE REPRODUCTIVE SYSTEM
USES:
1. SUBJECTIVE DATA -
FOCUS INTERVIEW
2. OBJECTIVE DATA:
HEALTH RECORDS, THE RESULTS OF LABORATORY
TESTS, AND X-RAYS
PHYSICAL ASSESMENT
 QUESTIONS
GENERAL RELATED TO

Focus QUESTIONS ILLNESS OR

INFECTION

Interview QUESTION
RELATED TO PAIN
QUESTIONS
RELATED TO
SYMPTOMS

QUESTIONS
AGE RELATED
ABOUT
QUESTIONS
BEHAVIOUR

THE MALE REPRODUCTIVE SYSTEM

FOCUSED INTERVIEW FOCUSES ON
INTERNAL EXTERNAL
INFORMATION ABOUT THE ANATOMY ENVIRONMENT ENVIRONMENT
AND PHYSIOLOGY OF THIS BODILY
SYSTEM.
 General
Questions
Question Rationale

1
DO YOU HAVE ANY THESE INQUIRIES COULD ELICIT THE
CONCERNS ABOUT YOUR MALE PATIENT TO TALK ABOUT ANY
SEXUAL HEALTH? HAVE YOU REPRODUCTIVE HEALTH ISSUES.
HAD CONCERNS IN THE PAST?
IF SO, PLEASE TELL ME ABOUT
THOSE CONCERNS

2
 Questions related to
illness or infection
Question Rationale

HAVE YOU EVER HAD A SEXUALLY

TRANSMITTED DISEASE (SUCH AS
1 HERPES, GONORRHEA, SYPHILIS, OR
CHLAMYDIA)? IF THE PATIENT ANSWERS THE PATIENT SHOULD BE
“YES”: INFORMED BY THE NURSE ON THE
WAS IT TREATED? RISKS AND MODES OF STD
DID YOU INFORM YOUR PARTNER?
TRANSMISSION IN ADDITION TO
DID YOU HAVE SEXUAL RELATIONS
WITH YOUR PARTNER WHILE YOU PREVENTATIVE TECHNIQUES.
WERE INFECTED?
IF THE PATIENT ANSWERS “YES”: 2
DID YOU USE CONDOMS?
WHAT TREATMENT DID YOU
RECEIVE?
 Questions Related
to Symptoms
Question
HAVE YOU NOTICED ANY SWELLING
1 OF YOUR SCROTUM, PENIS, OR
SURROUNDING AREAS?
IF SO, WHEN DID IT START?
IS IT PAINFUL?
HAS THERE BEEN ANY PATTERN
TO THE SWELLING: AN INCREASE,
DECREASE, OR UNCHANGED
PATTERN?
WHAT TREATMENTS HAVE YOU
TRIED?
Rationale
THE QUESTIONS ALLOWS FOR THE
IDENTIFICATION OF PROBLEMS OF
RAPID ONSET AS THEY CAN
POTENTIALLY BE MORE
DETRIMENTAL. SWELLING IN THE
INGUINAL AREA MAY INDICATE THE
PRESENCE OF A HERNIA. IN THE
SCROTAL AREA, SWELLING COULD
BE CAUSED BY AN ACUTE OR
CHRONIC INFLAMMATORY
PROCESS, A HYDROCELE, SCROTAL
2OR SCROTAL HERNIA.
EDEMA,
 Questions related
to Pain
Question Rationale

THE QUESTION AIDS THE NURSE IN

1 ARE YOU HAVING ANY IDENTIFYING IF THE ISSUE IS
PAIN IN THE AREA CURRENT, A PAST ISSUE, OR
CHRONIC.
NOW?

2
 Questions related
to Behaviors
Question Rationale

REGULAR GENITAL SELF-

1 EXAMINATION IS CRUCIAL FOR
DO YOU CHECK
EARLY DETECTION OF NECESSARY
YOUR GENITALS ON CHANGES, AND TEACHING MAY BE
A ROUTINE BASIS? RECOMMENDED IF THE PATIENT IS
NOT PERFORMING SELF-
EXAMINATION.

2
 Age Related
Questions
Infants
1 HAVE YOU NOTICED ANY REDNESS,
SWELLING, OR DISCHARGE THAT IS
DISCOLORED OR FOUL SMELLING IN
THE CHILD'S GENITAL AREAS?
School-age/ Adolescents
HAS ANYONE EVER TOUCHED
2 YOU WHEN YOU DIDN'T WANT HIM
OR HER TO? WHERE?
Teenager
3 HAVE YOU EXPERIENCED ANY
EPISODES OF WET DREAMS
RECENTLY?
Older male
HAVE YOU NOTICED ANY
4 CHANGES IN THE TIME THAT YOUR
ERECTION MAY LAST?
2
 Questions related to the External
Environment/ Internal Environment
Question Rationale

DO YOU USE PROTECTIVE THE USE OF PROTECTIVE EQUIPMENT SUCH

1 EQUIPMENT WHEN ENGAGED IN
WORK OR ATHLETIC
ACTIVITIES?
AS ATHLETIC SUPPORTS AND CUPS CAN
SIGNIFICANTLY DECREASE THE RISK OF
TESTICULAR DAMAGE.

DO YOU TAKE ANY PRESCRIBED OR MEDICATIONS, HERBS, DIETARY

1 OTC MEDICATIONS, HOME
REMEDIES, HERBAL OR CULTURAL
MEDICINES, OR DIETARY
SUPPLEMENTS?
SUPPLEMENTS, AND HOME REMEDIES CAN
2
INTERACT OR INTERFERE WITH EACH
OTHER, POTENTIALLY CAUSING SIDE
EFFECTS THAT AFFECT REPRODUCTIVE
FUNCTIONING.
 Physical
Assessment
EQUIPMENT EXAMINATION:
GOWN AND DRAPE CLEAN INSPECTION PALPATION
NONSTERILE EXAMINATION
GLOVES
EXAMINATION LIGHT
FLASHLIGHT
LUBRICANT SLIDES
SWABS TO OBTAIN A
SPECIMEN OF ABNORMAL
DISCHARGE
 1. Pubic hair: normal distribution amount, texture and
Inspection cleanliness, pubic hair is distributed heavily at the
symphysis pubis in a diamond- or triangular-shaped
pattern, thinning out as it extends toward the umbilicus,
absence of small bluish gray spots or nits ( eggs)
2.Penis: size, pigmentation, glans location of
dorsal vein
3.Urinary meatus: should be located in the
center of the tip of the penis

4. Scrotum: shape, how it hangs

unsupported, pear shape, left side hanging
lower than the right

5. Inguinal area: should be flat, observe

for any lumps or masses
 1. The penis: place the gland between your thumb

palpation and forefinger, note any tenderness or discharge

2. The scrotum: Gently palpate both left and

right scrotal sacs, Each scrotal sac should be
nontender, soft, and boggy

3. Testes: Each testes should be nontender,

oval shaped, walnut-sized, smooth, elastic, and
solid.
4. Epididymis

5. Spermatic cord: The cord should feel

thin, smooth, nontender to palpation, and
resilient.uinal area (should be flat, observe
for any lumps or masses)
 6. Inguinal lymph chain
palpation Use the pads of your first three
fingers

Start superficially, then move

deeper in a circular motion.

Confirm nonpalpable nodes and

nontender area.

7. Sacrococcygeal and perianal areas

Use gentle pressure for palpation.

The areas should be nontender and

without palpable masses.
palpation 8. Bulbourethral Gland and Prostate Gland
Lubricate right index finger.
Insert finger gently into anus.
Avoid right angle insertion to prevent pain.
Pause for sphincter muscle tightening.
Resume insertion as muscle relaxes.
Press thumb against perianal area for
stability.
Palpate bulbourethral gland gently.
Continue insertion and palpate prostate
gland.
Confirm smooth, firm, non-tender texture.
Ensure gland doesn't extend more than 1
cm.
 Abnormal Findings of the Penis
Hypospadias
It is a birth defect in which the opening of the
urethra is located on the underside of the penis
instead of the tip.

Peyronie’s Disease
A condition where hard plaque forms in the deeper
tissues under the skin of the penis and are palpable
which results in pain and bending of the penis during
erection.

Carcinoma
It appears as reddened nodule
growth or ulcer-like lesions
which usually occur in the
glands.
Genital Warts
A Sexually transmitted disease that is caused by human papillomavirus
(HPV) , and genital warts rapidly growing papular lesions.

Syphillitic Chancre
These non tender lesions appear as round or oval reddened ulcers. A
chancre often is the first symptom of primary syphilis, a sexually
transmitted diseas.

Genital Herpes
A sexually transmitted disease caused by herpes simplex virus
(HSV).These painful, small vesicle appear in clusters on any part of the
surface of the pennis. The area around the vesicle erythematous
 Abnormal Findings of the Scrotum
Hydrocele
A fluid-filled, non-tender mass that
occurs within the tunica vaginalis.

Scrotal hernia
An indirect inguinal hernia located
within the scrotum

Testicular tumor
A painful nodule of the testes. As it
grows. The entire testicles seem to be
overtaken
 Orchitis
The inflammatory process result in painful, tender, and swollen testes.

Torsion of the spermatic cord

Torsion occurs with the greatest frequency in adolescents. The twisting of
the testicle or the spermatic cord creates edema and pain, requiring
immediate surgical intervention.

Small Testes
Testes are considered small when they are less than 2cm (0.78in) long.
Atrophy may occur in liver disease, in orchitis, and with estrogen
administration.
Abnormal Findings of the Perianal area
Pilonidal Cyst
A fluid-filled sac located in the
sacrococcygeal area at the midline near
the crease of the buttocks.

Anal Fissure
Tears or splits in the anal mucosa that
are usually seen in the posterior anal
area, are usually associated with the
passage of hard stools or prolonged
diarrhea.

Hemorrhoids (Internal)
Varicosities of the hemorrhoidal veins of
the anus or lower rectum.
 Reference
D’Amico, D. and Barbarito, C. (2016 ). Health and Physical Assessment in Nursing.
3rd.ed. Pearson. United States of America

Marieb, E. N., & Hoehn, K. (2013). Human Anatomy and Physiology ( 9th ed.). San
Francisco, CA: Benjamin Cummings

Bui, T. (2023, August 8). Anatomy, abdomen, and pelvis: Inguinal lymph node.
StatPearls
[Internet]. https://www.ncbi.nlm.nih.gov/books/NBK557639/