Assessing the Male Breasts and Reproductive System

Diagnostics

Prostate-specific antigen (PSA), prostate biopsy, urethral specimens

Common STIs

Gonorrhea, chlamydia, genital herpes, HPV, HIV, syphilis

4 P’s of sexual history

Partners, practices, protection, and past STIs

Health promotion

Testicular self-exams, prostate cancer screening

Benign prostatic hypertrophy

Noncancerous enlargement of the prostate gland

Hydrocele

Sac of clear fluid in the scrotum

Epididymitis

Inflammation of the epididymis

Erectile dysfunction

Inability of an adult male to achieve an erection; impotence

Sequence of assessment

Inspecting and palpating the male breasts, inspecting the male genitalia

Inspecting/palpating the male breast normal findings

Breasts are symmetric with even color, no lesions, dimpling, lumps, or masses, areola is smooth and uniform color, nipple is everted with skin intact and without drainage, axillary area has no lumps

Inspecting/palpating the male breast abnormal findings

Lumps or masses palpated, gynecomastia, erythema of skin, scaling of nipple, open sore, skin retraction, nipple discharge

Gynecomastia

Enlargement of breast tissue in males due to hormonal changes, medications, or underlying health conditions

Inspecting the penis normal findings

Pink to light brown in Caucasians, light to dark brown in dark-skinned people, smooth, no hair, dorsal vein is visible, no lesions, discharge, nits, or lice

Inspecting the penis abnormal findings

Swelling, lesions, discoloration, unusual discharge, curvature, or pain

Tinea cruris

Ringworm of the groin (jock itch)

Inspecting the prepuce (foreskin) normal findings

Circumcised foreskin is smooth and pink, uncircumcised foreskin easily retracts, smegma may or may not be present

Inspecting the prepuce (foreskin) abnormal findings

Phimosis, paraphimosis, balanitis

Smegma

Thick, cheesy secretion that accumulates under the labia minora or the male foreskin

Phimosis

Stenosis or narrowing of foreskin so that it cannot be retracted over the glans penis

Paraphimosis

Condition where a retracted prepuce cannot be pulled forward to cover the glans

Balanitis

Inflammation of the skin covering the glans penis

Inspecting the urethral meatus normal findings

Pink, smooth, located at the center of the glans

Inspecting the urethral meatus abnormal findings

Opening has discharge, epispadias, hypospadias

Epispadias

Congenital defect where the urinary meatus is located on the upper surface of the penis

Hypospadias

Abnormal congenital opening of the male urethra on the undersurface of the penis

Epidermoid cysts

Small, benign lumps that form beneath the skin, typically filled with keratin

Inspecting the scrotum normal findings

Skin is a darker pigmentation, left testis hangs lower than the right testis

Inspecting the scrotum abnormal findings

Swelling, lesions, empty scrotal sac, small testis

Inspecting the anus normal findings

Darker skin color

Inspecting the anus abnormal findings

Hemorrhoids, rectal bleeding, protrusion of rectal mucosa

Inspecting the inguinal area normal findings

Skin is smooth, free from lumps or bumps

Inspecting the inguinal area abnormal findings

Inguinal hernia, tinea cruris

Inguinal hernia

Protrusion of tissue through the abdominal wall or inguinal canal, often causing a bulge