MALE GENITALIA

Structure & Function:

 External Genitalia:
Penis and the Scrotum
 Internal Genitalia:
Testes and Spermatic Cord
 Inguinal Area
Hernias can be common
 Anus & Rectum
 Prostate
Prostate gland – thin, milky substance that promotes sperm motility and
neutralize female acidic vaginal secretions
Structure & Function:

 External Genitalia:
Penis and the Scrotum
 Internal Genitalia:
Testes and Spermatic Cord
 Inguinal Area
Hernias can be common
 Anus & Rectum
 Prostate
Prostate gland – thin, milky substance that promotes sperm motility and
neutralize female acidic vaginal secretions
Older Adult Considerations

 Prostatic hyperplasia
- Enlargement of the prostate gland

 Has become increasingly common in men age over 40

Assess for:

 Pain
 Lesions
 Discharge
 Lumps, Swelling, Masses
 Urination
 Sexual Dysfunction
 Bowel Patterns
 Stool
 Itching and Pain
Testicular Self-Examination
Preparing the client

 Instruct the client to empty his bladder

 If urine specimen is necessary, provide a container
 Provide a drape for the patient
 Explain the procedures and that he will be asked to stand (if able) for most of
the examination
 POSITIONS
• Whichever
position the
examiner
decides would
be the best for
the particular
client and
examination
• Determine if the
client is as
comfortable as
possible
Physical Assessment

 Wear disposable gloves

 Prepare the client thoroughly to put the client at the greatest ease
 Perform examination professionally and reserve client's modesty
 Preserve the client’s privacy
 Inspect and palpate penis, scrotum, and inguinal area for rashes,
inflammation, lesions, and lumps
 During the testicular examination, describe the importance of testicular self-
examination, ad explain how to perform it as you perform it
INSPECTION & PALPATION

Inspect the base of the penis and

the pubic hair

✔️ Pubic hair is coarser

✔️ Base of the penis and pubic hair are free of
excoriations, erythema, and infestations
*OLDER ADULT CONSIDERATIONS:
Pubic hair may be gray and sparse; penis becomes
smaller and testes hang lower in the scrotum
Abnormal findings:

 👎 Absence/scarcity of pubic hair = client receiving chemotherapy

 👎Pediculosis pubis = Lice infestation in penis or pubic hair

INSPECTION & PALPATION

Inspect the skin of the shaft

✔️ The skin is wrinkled and hairless

✔️Free of rashes, lesions or lumps

*CULTURAL CONSIDERATIONS:
Pebertal rites in some cultures include
slitting the penile shaft
Abnormal findings:

 👎 Rashes, lesions, or lumps = May indicate STI or cancer

INSPECTION & PALPATION

Palpate the shaft

✔️Nonerect: usually soft, flaccid, and

nontender
Abnormal findings:

 👎 Tenderness= May indicate inflammation/infection

INSPECTION & PALPATION

Inspect the foreskin

✔️ For uncircumcised: intact and

uniform in color with the penis
Abnormal findings:

 👎 Discoloration = May indicate scarring/infection

INSPECTION & PALPATION

Inspect the glans

✔️ Size & shape may vary: rounded,

broad, or even pointed
✔️ Surface: smooth, free of lesions
and redness
✔️ urinary meatus: slit-like and found
in the center of the glans
*CULTUTRAL CONSIDERATIONS
If pubertal mutilation has occurred,
actual discharge of urine and semen
will occur at location of the shaft
oppening
Abnormal findings:

 👎 Discoloration = May indicate scarring/infection

INSPECTION & PALPATION

Inspect the glans

✔️ Size & shape may vary: rounded,

broad, or even pointed
✔️ Surface: smooth, free of lesions
and redness
✔️ urinary meatus: slit-like and found
in the center of the glans
 Abnormal findings:

 👎 Chancres = Red oval ulcerations

= syphilis, genital warts, herpes
 👎 Phimosis = Cannot retract

 👎 Paraphimosis = Once retracted, cannot return

 👎 Hypospadias = displacement of the urinary
meatus to the ventral surface of penis
 👎 Epispadias = displacement of the urinary meatus
to the dorsal surface of penis
INSPECTION & PALPATION

Palpate for urethral discharge

✔️ Free of discharge
Abnormal findings:

 👎 Yellowish discharge = Gonorrhea

 👎 Clear/white discharge = Urethritis

SCROTUM: INSPECTION & PALPATION

Inspect the size, shape, and

position of the scrotum
✔️ varies in size; scrotal sac hangs
below or at the level of the penis; left
side hangs lower compared to the right
Abnormal findings:

 👎 Enlarged scrotal sac = May

result from fluid (hydrocele), blood
(hematocele), bowel (hernia), or
tumor (cancer)
SCROTUM: INSPECTION & PALPATION

Inspect the scrotal skin

✔️ Thin and rugated (crinkled) with
little hair dispersion
✔️ Color is slightly darker than the
penis
✔️ Sebaceous cyst are normal
Abnormal findings:

 👎 Rashes, lesion, and

inflammation = Abnormal
SCROTUM: INSPECTION & PALPATION

Palpate the scrotal contents

✔️ Testes are ovoid (3.5-5cm long,
2.5cm wide and 2.5 cm deep)
✔️ Equal and bilaterally in size and
shape
✔️ Sebaceous cyst are normal
*OLDER ADULT CONSIDERATIONS
Testes do not get smaller with age,
may decrease in size with long-term
illness
INGUINAL AREA : INSPECTION & PALPATION
Inspect for inguinal and femoral
hernia

✔️ Free from bulges

👎 Bulges at external inguinal ring or

femoral canal: may signal a hernia

Palpate for inguinal hernia and

inguinal nodes

✔️Bulges/masses are not palpated

👎 Bulges: may indicate hernia

INGUINAL AREA : INSPECTION & PALPATION

Palpate inguinal lymph nodes

✔️ No enlargement/tenderness =
normal
👎 Enlarged/Tenderness: may indicate an
infection of the penis or scrotum

Palpate for femoral hernia

✔️Bulges/masses are not palpated

👎 Bulges palpated: as client bears down

PALPATION

Prostate Gland

✔️ Nontender and rubbery

✔️Has two lateral lobes divided by a
median sulcus
Abnormal findings:

 👎 Swollen, tender= Acute prostitis

 👎 Enlarged, smooth, firm, slightly elastic = Benign Prostatic Hypertrophy
 👎 Hard area on prostate, irregular nodules = Cancer
 INSPECTION
Check stool

✔️ Normally semi-solid, brown and

free of blood
Abnormal findings:

 👎 Black stool = May indicate upper gastrointestinal bleeding

 👎 Gray/tan stool = Lack of bile pigment
 👎 Yellow stool = Steatorrhea (increased fat content)
 👎 Blood detected in stool = Cancer of the rectum/colon
REFERENCES:

 WEBER, J., KELLEY, J., (2014). Health Assessment in Nursing 5th Edition.
Lippincont Williams & Wilkins