From the Guidelines
A comprehensive male genitourinary (GU) physical exam should include a thorough examination of the penis, testes, epididymides, vasa, and a digital rectal examination, as recommended by the American Urological Association and American Society for Reproductive Medicine 1. When performing the exam, the following key components should be included:
- Examination of the penis, including the location of the urethral meatus
- Measurement and palpation of the testes
- Checking for the presence and consistency of the vasa and epididymides
- Checking for the presence of a varicocele
- Assessment of body habitus and secondary sex characteristics, including hair distribution and breast development
- A digital rectal examination, as outlined in the guidelines 1. It is essential to maintain the patient's dignity throughout the exam by explaining each step, using drapes, and wearing gloves. This systematic approach helps identify conditions such as testicular masses, hernias, varicoceles, epididymitis, and sexually transmitted infections. By following these guidelines, healthcare providers can ensure a thorough and effective male GU physical exam, prioritizing morbidity, mortality, and quality of life outcomes.
From the Research
Male Genitourinary (GU) Physical Exam
The male genitourinary physical exam is an essential part of a comprehensive health checkup. Here are some key points to consider:
- A genitourinary assessment should begin with obtaining a focused history from the patient, including any symptoms or concerns they may have 2.
- The exam should include an inspection of the genitalia, followed by palpation and possibly transillumination 3.
- Digital rectal examination (DRE) is an important part of the exam, especially for men with elevated prostate-specific antigen (PSA) levels 4, 5, 6.
- The use of DRE and PSA testing together provides a more complete evaluation of the prostate gland for malignant involvement 6.
- Transrectal ultrasonography (TRUS) may be used in some cases, but is typically reserved for patients with abnormal DRE or elevated PSA results 6.
Key Components of the Male GU Exam
Some key components of the male GU exam include:
- Inspection of the penis, scrotum, and testes
- Palpation of the testes, epididymis, and spermatic cord
- DRE to assess the prostate gland
- Assessment of urinary symptoms, such as frequency, urgency, or pain
Special Considerations
Special considerations for the male GU exam include: