What is included in the physical exam of male patients with urethritis?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Most patients with urethritis do not appear ill and do not present with signs of sepsis. The primary focus of the examination is on the genitalia.

Examination in male patients with urethritis includes the following:

  • Inspect the underwear for secretions

  • Penis: Examine for skin lesions that may indicate other STDs (eg, condyloma acuminatum, herpes simplex, syphilis); in uncircumcised men, retract the foreskin to assess for lesions and exudate

  • Urethra: Examine lumen of the distal urethral meatus for lesions, stricture, or obvious urethral discharge; palpate along urethra for areas of fluctuance, tenderness, or warmth suggestive of abscess or for firmness suggesting foreign body

  • Testes: Examine for evidence of mass or inflammation; palpate the spermatic cord, looking for swelling, tenderness, or warmth suggestive of orchitis or epididymitis

  • Lymphatics: Check for inguinal adenopathy

  • Prostate: Palpate for tenderness or bogginess suggestive of prostatitis

  • Rectal: During the digital rectal examination, note any perianal lesions


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