Penis and Scrotum Exam: What to Expect During a Genital Examination

What Is a Penis and Scrotum Examination?

A penis and scrotum examination is a physical examination of the male external genitalia performed by a healthcare professional. It involves visual inspection and gentle palpation (touching) of the penis, foreskin, glans, scrotum, and testicles to check for abnormalities, infections, or other health concerns.

A genital examination is one of the most common medical procedures performed on individuals with male anatomy. Healthcare providers routinely conduct these examinations to diagnose a wide range of conditions, from sexually transmitted infections (STIs) to skin problems and testicular abnormalities. Despite being a routine procedure, many people feel anxious about having their genitals examined by a healthcare professional, which is entirely understandable and normal.

The examination itself is straightforward and typically takes only a few minutes to complete. The healthcare provider will use their hands, protected by medical gloves, to visually inspect and gently feel the external genitalia. Throughout the examination, they will explain what they are doing and what they observe, helping to make the process less intimidating and more transparent for the patient.

Understanding what happens during a genital examination can significantly reduce anxiety and help you feel more prepared for your appointment. This comprehensive guide covers everything you need to know about penis and scrotum examinations, including why they are performed, how to prepare, what happens during the procedure, and what conditions they can help diagnose.

Who performs genital examinations?

Several types of healthcare professionals are qualified to perform genital examinations, including primary care physicians, urologists, sexual health specialists, nurses with specialized training, and midwives. The specific provider you see may depend on your symptoms, the reason for the examination, and what type of healthcare facility you visit.

Regardless of who performs the examination, all healthcare professionals are trained to conduct genital examinations in a respectful, professional manner. They understand that many patients feel vulnerable or embarrassed during these procedures and are skilled at creating a comfortable environment. You can request a healthcare provider of a particular gender if that would make you feel more comfortable, though this may not always be possible depending on staff availability.

How Do I Prepare for a Genital Examination?

No special preparation is required for a penis and scrotum examination. However, if a urine sample will be needed for STI testing, you should avoid urinating for approximately 2 hours before your appointment to ensure accurate test results. Normal hygiene practices before your appointment are sufficient.

One of the advantages of genital examinations is that they require minimal preparation on your part. You do not need to follow any special diet, fast, or take any medications before the examination. Simply maintain your normal hygiene routine - there is no need to clean more thoroughly than usual, and using strong soaps or douches is actually not recommended as they can irritate delicate genital skin.

The main consideration for preparation relates to urine testing. If your healthcare provider plans to test you for sexually transmitted infections such as chlamydia, gonorrhea, or mycoplasma, they may need a urine sample. For these tests to provide accurate results, the urine should contain cells from inside the urethra (the tube that carries urine out of the body). If you have urinated recently, these cells may have been washed away, potentially affecting the test's accuracy.

Therefore, if you know or suspect that a urine test will be part of your appointment, try to avoid urinating for about two hours beforehand. If you're unsure whether you'll need a urine test, you can always call the clinic in advance to ask, or simply plan to hold your urine for a couple of hours before your appointment just in case.

You will be asked questions before the examination

Before the physical examination begins, your healthcare provider will ask you several questions about your symptoms, medical history, and the reason for your visit. These questions help them understand what to look for during the examination and whether any additional tests might be needed. The questions may include:

• What symptoms have you noticed and when did they start?
• Have you had any discharge from the penis?
• Do you experience any pain or discomfort?
• Have you noticed any lumps, bumps, or skin changes?
• Are you sexually active, and do you use protection?
• Have you had any previous STIs or genital health problems?
• When were you last tested for STIs?

These questions are a normal part of the medical consultation and help ensure you receive appropriate care. Healthcare providers ask these questions to many patients every day, so there's no need to feel embarrassed about discussing intimate matters. Being honest and thorough in your answers will help your provider give you the best possible care.

What Happens During the Examination?

During a genital examination, the healthcare provider will ask you to remove clothing from your lower body. They will visually inspect and gently feel the penis, including retracting the foreskin if present, and examine the scrotum and testicles. The examination typically takes only 3-5 minutes and should not cause pain.

Understanding exactly what happens during a genital examination can help reduce anxiety and make the experience more comfortable. The examination follows a systematic approach that allows the healthcare provider to thoroughly assess your genital health while maintaining your comfort and dignity.

When you enter the examination room, the healthcare provider will explain the examination process and what they plan to do. This is an opportunity for you to ask any questions or express any concerns you might have. The provider will then give you privacy to remove your clothing from the waist down, often providing a paper drape or sheet for you to cover yourself until they are ready to begin.

During the examination itself, the healthcare provider will wear medical gloves. They will explain each step as they proceed, telling you what they are doing and what they observe. This transparency helps you understand the process and reduces uncertainty about what is happening.

Tell the examiner if you feel anxious

Feeling nervous before or during a genital examination is completely normal and very common. Many people feel uncomfortable about having an intimate part of their body examined, regardless of how routine the procedure is from a medical perspective. Healthcare providers understand this and are trained to help you feel as comfortable as possible.

If you feel anxious, don't hesitate to tell the healthcare provider. They can take extra time to explain the procedure, proceed more slowly, or take breaks if needed. Some patients find it helpful to take slow, deep breaths during the examination, while others prefer to focus on something else in the room. Find whatever coping strategy works best for you.

Remember that you have the right to ask questions at any time and to stop the examination if you need a break or feel too uncomfortable to continue. A good healthcare provider will respect your boundaries and work with you to make the experience as positive as possible.

What happens if I get an erection?

One concern many people have about genital examinations is the possibility of getting an erection during the procedure. This is a completely natural physiological response that can occur without any sexual arousal. The penis contains nerve endings that can respond to touch by causing blood flow to the erectile tissues, regardless of the context in which that touch occurs.

When the penis is touched or stimulated, even during a medical examination, nerve signals travel from the penis to the lower spinal cord and back, potentially triggering an erection. This is an involuntary reflex that you cannot consciously control, similar to how your pupils dilate in response to light changes.

If you do get an erection during the examination, the healthcare provider will handle the situation professionally. You or the examiner can pause the examination briefly until the erection subsides. There is no need to feel embarrassed - healthcare providers who perform genital examinations encounter this situation regularly and understand that it is a normal physical response, not a sign of sexual interest or impropriety.

Examination of the penis

The examination of the penis typically occurs while you are lying on your back on an examination table, though you may sometimes be asked to stand. The healthcare provider will visually inspect the entire penis, looking at the skin for any spots, bumps, rashes, sores, or other abnormalities.

If you have a foreskin (are uncircumcised), the provider will gently retract it to examine the glans (head of the penis) and the inner surface of the foreskin. This area is checked for signs of infection, inflammation, or other problems. The provider will also examine the urethral opening (the hole at the tip of the penis) for any discharge or abnormalities.

The examination is conducted gently and should not cause pain. If you experience any discomfort, inform the healthcare provider immediately. They can adjust their technique or investigate whether the discomfort might indicate a problem that needs attention.

Examination of the scrotum

The scrotal examination is typically performed with you lying down, though standing may sometimes be requested. The healthcare provider will gently feel each testicle and the surrounding structures, including the epididymis (a coiled tube behind each testicle where sperm mature and are stored).

During the scrotal examination, the provider is checking for several things: the size, shape, and consistency of each testicle; any lumps, bumps, or hard areas; swelling or tenderness; and the condition of the epididymis and spermatic cord (the structure that connects the testicle to the body and contains blood vessels and the vas deferens).

It's normal for one testicle to be slightly larger than the other or to hang a bit lower - this is common and usually not a cause for concern. The healthcare provider knows what normal variations look like and will be able to distinguish these from abnormalities that might require further investigation.

Why Is a Genital Examination Performed?

Genital examinations are performed to diagnose various conditions including sexually transmitted infections, skin conditions, testicular lumps or changes, foreskin problems, and unexplained pain or swelling. They may also be part of routine health check-ups or STI screening.

Healthcare providers recommend genital examinations for many different reasons, ranging from investigating specific symptoms to routine preventive health screening. Understanding why these examinations are important can help you appreciate their value and feel more comfortable about having one.

In many cases, a genital examination is the only way to properly diagnose certain conditions. While you can describe your symptoms to a healthcare provider, many genital health problems can only be accurately identified through visual inspection and physical examination. Laboratory tests, while valuable, often cannot replace the information gained from a careful physical examination.

Common reasons for genital examinations

There are numerous situations that may prompt a healthcare provider to recommend a genital examination. Here are some of the most common reasons:

Spots, bumps, and rashes: Unusual marks on the genital skin can have many causes, ranging from harmless conditions to sexually transmitted infections. Conditions such as genital warts (condyloma) and herpes cause visible changes on the skin that can be identified during an examination. However, many bumps and spots turn out to be completely harmless, such as pearly penile papules (small bumps around the rim of the glans) or sebaceous glands (oil-producing glands that are normal parts of skin anatomy).

Irritated or problematic skin: Itching, burning, swelling, or pain on the genital skin often indicates an infection or irritation. These problems can result from bacterial or fungal infections, often caused by washing the area with soap, which removes protective natural oils and allows harmful microorganisms to thrive. A healthcare provider can identify the cause and recommend appropriate treatment.

Discharge from the urethra: Unusual discharge from the opening of the penis may indicate a sexually transmitted infection such as chlamydia, gonorrhea, or mycoplasma genitalium. While a urine test can often detect these infections, an examination allows the provider to assess the discharge and may involve taking a swab directly from the urethral opening for more accurate testing.

Foreskin problems: Difficulty retracting the foreskin (phimosis), a foreskin that gets stuck when retracted (paraphimosis), or tears and cracks in the foreskin (often caused by the frenulum, the small connecting tissue) are common reasons for genital examinations. These conditions can often be treated, sometimes requiring minor procedures.

Testicular lumps or changes: Any new lump in the testicle or changes in the size, shape, or consistency of a testicle should be examined by a healthcare provider. While most lumps turn out to be benign (non-cancerous), testicular cancer is one of the most common cancers in young men, and early detection significantly improves treatment outcomes.

Scrotal swelling or pain: Swelling or pain in the scrotum can have various causes, including infection (epididymitis or orchitis), fluid accumulation (hydrocele), dilated veins (varicocele), or testicular torsion (a medical emergency where the testicle twists on its blood supply). An examination helps determine the cause and appropriate treatment.

Where Can I Get a Genital Examination?

Genital examinations can be performed at various healthcare facilities including primary care clinics, sexual health clinics, urology departments, and specialized men's health clinics. Sexual health clinics often offer confidential services, sometimes without requiring an appointment.

Several types of healthcare facilities offer genital examinations, and the best choice for you may depend on your specific concerns, location, and preferences. Understanding your options can help you access appropriate care more easily.

Primary care clinics (general practitioners): Your regular doctor's office is often a good first point of contact for genital health concerns. Primary care providers are trained to perform genital examinations and can diagnose many common conditions. If specialized care is needed, they can refer you to an appropriate specialist.

Sexual health clinics: These specialized clinics focus specifically on sexual health, including STI testing and treatment, contraception advice, and genital health concerns. They often offer confidential services and may have walk-in availability without needing an appointment. Staff at these clinics are particularly experienced in discussing intimate health matters.

Urology departments: Urologists specialize in conditions affecting the urinary system and male reproductive organs. If you have concerns specifically about your testicles, such as a suspected lump, or complex foreskin problems, a urologist may be the most appropriate specialist.

Men's health clinics: Some areas have clinics specifically focused on men's health issues, including genital health. These clinics welcome anyone with male genitalia, regardless of gender identity, and often provide a comfortable environment for discussing intimate health concerns.

Young people's health services: Young people may be able to access genital examinations through youth health clinics or student health services, which often provide free or low-cost confidential care for people up to a certain age (typically 20-25 years old, depending on the service).

What Does a Genital Examination Cost?

The cost of a genital examination varies depending on your location, healthcare system, and type of facility. In many countries, sexual health services including STI testing are free or low-cost at public health clinics. Private consultations typically carry standard appointment fees.

The cost of a genital examination depends on several factors, including where you live, what type of healthcare facility you visit, and whether you have health insurance. In many healthcare systems, a genital examination performed at a primary care clinic or sexual health center costs the same as a standard medical appointment.

Sexual health clinics often provide free or reduced-cost services, particularly for STI testing and treatment. This is because preventing and treating sexually transmitted infections is a public health priority, and removing financial barriers helps ensure people can access necessary care. If cost is a concern for you, contact your local sexual health clinic to ask about their fee structure.

Testing for certain STIs may be free regardless of where you receive care, depending on your country's public health policies. Conditions covered by public health laws, such as chlamydia and gonorrhea, often have free testing and treatment available to encourage people to get tested and treated, thereby reducing transmission in the community.

How Can I Examine My Own Scrotum?

Regular self-examination of the scrotum helps you learn what is normal for your body and detect any changes early. Perform self-exams after a warm shower when the scrotal skin is relaxed. Gently roll each testicle between your fingers, feeling for lumps, changes in size, or areas of hardness.

While professional medical examinations are important, regularly examining your own scrotum is a valuable practice that can help you detect changes early. By becoming familiar with the normal feel of your testicles and surrounding structures, you'll be better able to notice if something changes - and the earlier a problem is detected, the easier it usually is to treat.

Testicular self-examination is particularly important because testicular cancer, while relatively rare, is most common in men between ages 15 and 45 and has excellent survival rates when detected early. Most testicular cancers are first noticed by the person themselves or their partner, not during a routine medical examination.

How to perform a testicular self-examination

The best time to perform a testicular self-examination is during or right after a warm bath or shower. The warmth relaxes the scrotal skin and causes the testicles to hang lower, making them easier to examine thoroughly.

Step 1: Stand in front of a mirror if possible and visually inspect your scrotum for any swelling on the skin surface.

Step 2: Examine each testicle one at a time. Hold the testicle between your thumbs and fingers of both hands and gently roll it between your fingers. You're feeling for the testicle itself, which should be smooth and oval-shaped.

Step 3: Locate the epididymis, a soft, rope-like structure at the back of each testicle. This is normal and should not be mistaken for a lump.

Step 4: Feel for any lumps, bumps, or areas that are harder than the rest of the testicle. Also note any changes in size or shape compared to previous self-examinations.

Step 5: Compare both testicles. It's normal for one to be slightly larger or hang lower than the other, but any significant change from what's normal for you should be noted.

Step 6: If you notice any lumps, swelling, hardness, or other changes, contact a healthcare provider for an examination. Most lumps turn out not to be cancer, but it's important to have any changes checked.

What Happens After the Examination?

After a genital examination, your healthcare provider will discuss their findings immediately. If samples were taken for testing, results typically take a few days to a week. Based on the findings, you may receive treatment, further tests, or referral to a specialist.

Once the physical examination is complete, your healthcare provider will share their observations with you right away. In many cases, they can provide reassurance that everything appears normal, or they can identify obvious conditions that can be diagnosed visually, such as genital warts or fungal infections.

If samples were collected during the examination (such as urine samples or swabs), you'll typically need to wait several days to receive the results. Your provider will explain how you'll receive your results - this might be through a follow-up appointment, phone call, secure online portal, or text message, depending on the clinic's procedures and your preferences.

Based on the examination findings and any test results, your healthcare provider may recommend one or more of the following:

• Treatment: If a condition is diagnosed, you may receive medication (such as antibiotics for bacterial infections or antifungal cream for fungal infections) or other treatment recommendations
• Further testing: Additional tests such as blood tests, imaging studies (ultrasound), or specialized laboratory tests may be recommended
• Specialist referral: You may be referred to a specialist such as a urologist or dermatologist for further evaluation or treatment
• Follow-up appointment: A follow-up visit may be scheduled to monitor the condition or assess treatment effectiveness
• Partner notification: If an STI is diagnosed, you may be advised to inform sexual partners so they can also be tested and treated