Physical examination maneuver

Physical Exam

Male Genital Exam

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How to Perform

With the patient standing and the genitals exposed, inspect the area of concern, inguinal regions, penis, urethral meatus, and scrotum for skin changes, lesions, asymmetry, swelling, or a visible bulge. If present, ask the patient to retract the foreskin to inspect the glans and meatus, then ask the patient to return the foreskin to its normal position. Palpate the area of concern and gently examine each testis, epididymis, and spermatic cord separately, noting size, position, consistency, tenderness, and any mass. Then invert the scrotal skin with the index finger, follow the spermatic cord to the superficial inguinal ring, and ask the patient to cough or strain while feeling for an impulse against your finger. Repeat on the opposite side.

How to Interpret

Showing 2 of 7 findings

Urethritis

Visible urethral discharge at the meatus
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Varicocele

Palpable varicocele on standing scrotal examination with Valsalva
Rule in
Somewhat helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

Related Bedside Tests

Scrotal TransilluminationMembers
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Scrotal Transillumination
aka Scrotal diaphanoscopy
Rule in:IEHematocele, IEHydrocele, IEInguinoscrotal Hernia +2 more
Rule out:IEHematocele, IEHydrocele, IEInguinoscrotal Hernia +2 more
Cremasteric ReflexMembers
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Cremasteric Reflex
Rule in:ICTesticular Torsion, IESpinal Cord Lesion, IEUpper Motor Neuron Lesion
Rule out:SHTesticular Torsion, IESpinal Cord Lesion, IEUpper Motor Neuron Lesion
🎬Video coming soon
Abdomen Palpation
Rule in:VHExtrahepatic Biliary Obstruction, VHIntussusception, VHPyloric Stenosis +32 more
Rule out:VHHepatocellular Jaundice, HAppendicitis, SHDiverticulitis +32 more
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Costovertebral Angle Percussion
aka Murphy punch sign; Pasternatsky sign; Goldflam sign
Rule in:MHCystitis, NHNephrolithiasis, IEPerinephric Abscess +2 more
Rule out:NHCystitis, ICNephrolithiasis, IEPerinephric Abscess +2 more
Pelvic Bimanual ExamMembers
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Pelvic Bimanual Exam
Rule in:VHOvarian Cancer, MHPelvic Inflammatory Disease, IEEndometriosis +4 more
Rule out:SHPelvic Inflammatory Disease, MHOvarian Cancer, IEEndometriosis +4 more
🎬Video coming soon
Abdomen Auscultation
Rule in:VHRenovascular Hypertension, MHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more
Rule out:MHRenovascular Hypertension, NHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more

Related Systems / Regions

GenitourinaryPelvisReproductive

Related Diagnoses

CryptorchidismEpididymitisHydroceleInguinal HerniaTesticular CancerUrethritisVaricocele

Related Chief Complaints

Feeling of Heaviness in the ScrotumGroin BulgeGroin PainLower Abdominal PainNausea and VomitingScrotal DiscomfortScrotal MassScrotal PainScrotal SwellingTesticular Pain

References

Research in progress on one or more findings above; ratings may change.

  • Cocuzza MS, Tiseo BC, Srougi V, Wood GJA, Cardoso JPGF, Esteves SC, Srougi M. Diagnostic accuracy of physical examination compared with color Doppler ultrasound in the determination of varicocele diagnosis and grading: impact of urologists' experience. Andrology. 2020;8(5):1160-1166. PMID: 32289199
  • Crawford P, Crop JA. Evaluation of scrotal masses. Am Fam Physician. 2014;89(9):723-727. PMID: 24784335.
  • Rashid R, Khalabazyane B, Bee C, Ali M, Pugh T, Hanna L, et al. Urological Examination Compared to Ultrasonography in Testicular Lump Assessment: A Retrospective Cohort Study. Cureus. 2024;16(10):e72346. doi:10.7759/cureus.72346. PMID: 39583365.
  • van den Berg JC, de Valois JC, Go PM, Rosenbusch G. Detection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings. Invest Radiol. 1999;34(12):739-743. PMID: 10587869.
  • Prasad GR, Khan AU. Diagnostic Utility of the Absent Cremasteric Reflex and Prehn's Sign in Testicular Torsion: A Multicentre Retrospective Observational Study Comparing Clinical Examination with USG and Colour Doppler Imaging. J Clin Diagn Res. 2025;19(12):PC01-PC05. doi:10.7860/JCDR/2025/77982.22067.
  • Vesić S, Vukićević J, Daković Z, Tomović M, Dobrosavljević D, Medenica L, et al. Male urethritis with and without discharge: relation to microbiological findings and polymorphonuclear counts. Acta Dermatovenerol Alp Pannonica Adriat. 2007;16(2):53-57. PMID: 17992458.
  • Tasian GE, Copp HL. Diagnostic performance of ultrasound in nonpalpable cryptorchidism: a systematic review and meta-analysis. Pediatrics. 2011;127(1):119-128. PMID: 21149435. PMC3010084 (free full text).
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.