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Comedian Michael Shafar on his experience with testicular cancer
Whether there’s a lump or bump you’re worried about or you’re after a routine check-up to make sure everything’s in working order — if you haven’t had a genital examination before it’s normal to feel a bit nervous. Knowing what to expect during a male genital examination can help put your mind at ease.
A physical examination of your genital region — which includes your penis, scrotum, testes (testicles), anus and prostate — is vital for the detection of health conditions such as testicular cancer , Klinefelter syndrome , and penile and hormonal abnormalities. It’s also used for the diagnosis of hernia, urinary problems , skin conditions, and infection.
A genital examination will be done by your doctor. You’ll need to remove clothing covering the area. The examination may be carried out with you standing or lying down with a sheet or towel covering you. At any point you can ask questions or express any discomfort you’re feeling.
During the check-up, your doctor will assess the size and smoothness of your testes (testicles) and look for any abnormalities of your penis. They might also feel for scar tissue on the penis. They may also do a rectal examination of the prostate, in which they insert a lubricated, gloved finger into your anus.
If it’s suspected that you might have a sexually transmitted infection, your doctor will swab any skin lesion on the genital region or urethral discharge.
If you’re having issues with a tight foreskin, the doctor will examine the lack of mobility of your foreskin.
Overall, the process shouldn’t take more than a few minutes.
No, you don’t need to be erect for a genital examination. If you’re experiencing an issue that occurs during an erection, like bending , it can help to take a photo at home to show your doctor during your appointment.
Your genitals are incredibly sensitive, so it isn’t unusual for an erection to occur while you’re being physically examined. Don’t let it worry you, your doctor has seen it all before.
You can and should check yourself — getting familiar with the look and feel of your genitals can help you recognise when something has changed. However, it’s also important to get checked by a doctor as they’re trained to spot signs of problems you’re not aware of.
A testicular self-examination (TSE) is a quick and simple process. You might find it easier after a warm bath or shower when the skin of your scrotum is relaxed.
Standing in front of a mirror, start by checking for any swelling on the skin of your scrotum . Hold your scrotum in your hands and feel the size and weight of each testicle. Don’t worry if one testicle is a little bigger or hangs lower than the other, that’s normal.
Feel each testis, one at a time, by rolling it between your thumb and finger, checking for any lumps or swelling. The testes should feel firm, and the surface should feel smooth. You should be able to feel your epididymis, a soft tube toward the back of each testicle that carries sperm to the ejaculatory ducts. Check for any swelling in this area. You shouldn’t feel any pain when checking your testicles.
You should have a check-up every 12 months but see a doctor as soon as possible if you have noticed any changes to your genitals.
A genital examination should be part of a standard check-up for children and adolescents to check for normal development and puberty progression.
Comedian Michael Shafar on his experience with testicular cancer
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Penis Exam: When You Should Get One and What to Expect
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Dean J. (1998). ABC of sexual health: examination of patients with sexual problems. BMJ (Clinical research ed.), 317(7173), 1641–1643. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114437/ Testicularcancer.org (n.d) Monthly shower self-exam. Retrieved from:
https://www.testicularcancer.org/testicular-self-exam Fernandes, M., de Souza, L., & Cartafina, L. P. (2018). Ultrasound evaluation of the penis. Radiologia brasileira, 51(4), 257–261. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124582/ Niddk.nih.gov (n.d) Diagnosis of erectile dysfunction. Retrieved from:
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis
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Medically reviewed by Katelyn Hagerty, FNP
Opening yourself up and finding a therapist is one thing, but baring all for a professional to probe through your most sensitive bits, sounds about as fun as peeling a coconut with your toenails.
However, while penis exams may not be the most fun activity to sit through, there’s no denying how important this inspection can be for your health and wellbeing.
Think of it this way: taking your car in for a tuneup can help to ensure that your vehicle is in good shape and no surprises will disrupt its performance.
In just about the same way, getting an expert to examine how you perform erectile function can be critical to how well you power through during critical moments.
Examinations also help to rule out any suspected issues affecting your penis, and are instrumental in identifying conditions that could be affecting its performance.
If you’re curious about these examinations, you may have a few questions.
Unlike full physical exams (which you should also be getting regularly, by the way), penis exams refer to an examination of the male genital region — this means everything that makes up the internal and external bits of the penis, urethra and scrotum.
So, a penis exam is really a genital exam, in that everything in the region gets a looksee.
For a little clarity, an examination will also include parts like the testes, prostate, and epididymis (the duct where semen passes through).
Penis exams are usually carried out by a urologist. Understandably, a fifth of men would prefer someone of the same sex handling and scrutinizing their most sensitive regions, but a urologist may be male or female.
These exams are typically carried out as a routine part of a health evaluation. They are also commonly resorted to when a sexually transmitted disease or other genital condition is suspected.
When undergoing a penis examination, you may notice that your healthcare provider usually observes a standard procedure.
During this procedure, a common thread that’s usually noticed is the atmosphere of privacy, and deliberate caution usually taken by your preferred professionals.
When undergoing a physical examination, the urologist will carry out inspections that look into the general health of your penis and its appearance.
This procedure is usually carried out while the penis is flaccid.
While this process is taking place, anything that may affect the performance of erectile function will be focused on.
This means looking out for signs of conditions such as herpes, warts, ulcers, lumps or bumps, fungal infections, foreskin difficulties, urinary tract infection or erectile or sexual dysfunction.
To make these observations, key parts of the penile structure will be examined.
Your urologist may also ask questions about your medical history, sexual history and family history as they pertain to your sexual health, so be prepared for those, as well.
While carrying out a physical examination, a health professional will take some time to inspect the external appearance of the penis.
This may also involve facial and body hair, as well as enlarged breasts in the man being examined.
To perform a thorough job during the examination, your healthcare provider may be required to pull back the foreskin in uncircumcised men.
While the penis is flaccid, any pain, scarring, or physical restrictions in the penis are noted.
Penis exams also take into account the presence of any genital warts, as well as the position of the opening from where urine is discharged. Genital warts can signal HPV on the penis .
In examining the general appearance of the penis, signs of hormone deficiency are also observed. Likewise, abnormalities that may affect the production of hormones are also noted down.
A penis exam will also require an individual feel of the balls to confirm their texture and shape. To get a thumbs up during the inspection, the testes should feel smooth and uniform to the touch.
A look through the testes will also require a peep at the epididymis. The inspection of the latter should produce a similar symmetric and uniform feel.
Also to be examined are the veins of the testicles. These are typically examined standing up, and may be a cause for concern when they appear enlarged.
Also included in the penis examination is the prostate. Urologists examine the walnut-sized gland to assess its size and shape.
The prostate should appear to be firm, smooth, and symmetrical.
Because the prostate usually requires entry through the anus, the rectal exam is also used to look out for anal warts, hemorrhoids, or fissures in that region.
In certain cases, the abdomen together with reflexes around the penis and anus are also examined.
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To get a full view of what’s going on in your penis, your healthcare professional will likely carry out an ultrasound .
This procedure is very valuable for evaluating penile conditions such as trauma, priapism , Peyronie’s disease and erectile dysfunction .
Ultrasounds are carried out through transducers, which use soundwaves to create detailed imaging of the penis.
These devices are helpful in ensuring that the images produced during the examination are clear.
If you’d rather ease into things by taking matters into your own hands, personal examinations may be carried out on the penis.
Likewise, this process is also useful for identifying any differences before, or in-between visits with a healthcare professional.
When carrying a self-examination out, the objective is to explore any changes in the shape or feel of your genitals.
It is also important to be on the lookout for areas where pain is being experienced. This inspection should be carried out at least once a month .
To improve the accuracy of these exams, it is advisable to perform the test in the shower while the area is lathered up. This will help to relax the scrotum, making movement around the penis easier.
Each testicle is to be examined by gently rolling between the fingers. Also included in the check are cords that you should feel at the back of your testicles.
These searches are to be performed with a focus on any hard lumps, or strange bumps around the genitals. They are also to include any changes that you may observe in your privates.
In the event that you experience persistent difficulty with achieving or maintaining erections, it’s important to see a professional as soon as possible for an assessment to be made.
Where erectile dysfunction is suspected and your healthcare provider wants to take an ultrasound, the penis examination usually takes place on an erect penis.
This is usually made possible by injecting substances into the penis to induce rigidity. When this takes place, the following can be expected:
Screening for evidence of an endocrine disease such as diabetes and Addison disease ( a reduction in the production of hormones). These conditions may be responsible for erectile challenges being experienced, and are usually observed through laboratory tests.
This will be followed by measuring blood pressure and examining the urine to exclude the chances of diabetes. This condition has been known to affect the nerves, causing weakness or numbness in organ function.
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