Assessment of the Male Genitourinary System

I. Health History

A. Biographical

Age, race, occupation

B. Chief complaint

e.g. pelvic/rectal discomfort, hematuria, dysuria, Nocturia, sexual dysfunction, NAA

C. History of present illness

i.e. location, quality, quantity, timing (onset, frequency, duration), setting, factors that increase/decrease sx., associated manifestations

D. Past medical/surgical history

e.g. cryptorchid, STDs, medications (antihistamines, proscar), vasectomy, diabetes

E. Family history (first degree relations)

F. ROS

Smoking, sexual activity

II. Male psyche: “If it ain’t broke…!”

III. Exam equipment

Gloves, KY jelly, flashlight

IV. Breast assessment

A. Teach, explain, get permission

B. Inspect: bilateral symmetry, size

V. Bladder

A. Anatomy

B. Disease process

1. Signs/symptoms

2. TCCA (transitional cell carcinoma)

a. incidence

b. age

c. risk factors

VI. Assessment of the penis

A. Anatomy

B. Disease process

1. Signs/symptoms

2. Hypospadias

3. STD lesions

4. Penile cancer: Erythroplasia of Queyrat

Bowen’s disease

C. Teach, explain, get permission

Hygiene

D. Exam

1. Position

2. Inspect

3. Palpate

a. retract foreskin/replace foreskin

b. shaft

VII. Testicular assessment

A. Anatomy

B. Disease process

1. Signs/symptoms

2. Varicocele

3. Hydrocele

4. Spermatocele

5. Epididymitis

6. Hernia

7. Testicular cancer

a. incidence

b. age

c. risk factors

C. Teach, explain, get permission

TSE

D. Exam

1. Position

2. Inspect

3. Palpate

VIII. Assessment of the prostate

A. Anatomy

B. Disease process

1. Signs/symptoms

2. Prostatitis

3. BPH

4. PAC (prostatic adenocarcinoma

a. Incidence

b. Age

c. Risk factors

C. Teach, explain, get permission

D. Exam

1. Position

2. Inspect

3. Palpate: DRE

E. PSA

F. Ethics