This fall came the opportunity to switch rotations at the clinic. I have been providing physicals for males 30 years of age and older. Most are between 38 and 60. They all have been in relatively good health and respond to the demands of an exam in a cooperative manner though often with a degree of embarrassment. The older men would at times feel embarrassed by the appearance of a shrunken member and being probed rectally, which meant receiving an anuscope exam.

Overall, exams were very comprehensive; most would manage to tolerate the process but clearly felt a loss of control including acquisition of a semen sample. If unsuccessful, they would have to return for another attempt with deep prostate massage. No one failed when receiving this. Gasps and moans dominated that procedure.Switching to seeing younger men, ages 18 -22, were an opportunity to provide a “Developmental Exam,” which largely focused on genital health. The opportunity to offer a developmental exam was both rewarding as a means of offering young men health education information. and observing their naive reactions.

The exam was very detailed and likely humiliating for each one of them. It included a postural assessment and a genital exam to evaluate penis and testicular health, erectile response and strength, semen production, and rectal/prostate health. For all of them, this was not something that was expected. Most of them rarely saw a doctor and if they did, it was a cursory exam and maybe some updating of vaccinations and a hernia check. Even then, it was done in a very brief and superficial manner.

Here the exam was mandatory if one wished to be followed as a patient and always included the presence of a nurse to assist. This was often greeted with some degree of shock and disdain. The news about having to remove all clothing including socks tended to be received with protest and blushing. No exceptions were allowed.

Undressing was done at the start before even giving a urine sample and weight check. Doing so set the tone and expectation that this was an adult exam. More often than not, facial expressions changed; some looked shocked, others close to anger, and most close to tears and appearing terrified as briefs were removed. Automatically, each one of them covered over their genitals with their hands, now naked, awaiting further instructions while trying to avoid eye contact from the female nurse.

The first directive was to provide a urine sample under supervision. Some would tremble while others tried to look confident but grew tense as the nurse tugged the penis and wiped its meatus. Once completed came a quick rectal swab with a long 10 inch q-tip. It happened fast and before most realized what was done it was over. Nevertheless, a gasp was almost always assured! The nurse held a rectal thermometer buried deeply into their bottoms, and told them what was to follow.

The next aspect of the exam focused on genital and rectal health, which allowed for more privacy having the nurse leave. Evaluation of the penis meant measurements for length and girth while soft. To insure a flaccid penis, a swab was done which for all was shocking, uncomfortable and always caused shrinkage!

Next came, measurement of each testicle using an orchidometer, which some found humorous while most were embarrassed by having smaller testicles compared to those on the string! Palpitation of both testicles and feeling behind the scrotum often lead to some degree of penis engorgement, which was immediately followed by a rectal exam with the patient lying on his side. This allowed for good access to the scrotal area. A mere pressing of each testicle resulted in groans and clenching of cheeks. Most had never received a prostate exam let alone a finger up their bottoms. It was done quickly but surely resulted in causing firm erections, which allowed for subsequent penis measurement for length and girth as well as sampling of any preseminal fluid. All of them leaked!

An obligatory hernia exam including the inguinal canal was met with wide stares and gasps. At this point, there was a look of helplessness on their faces and visible throbbing being displayed by one’s rigid penis. Having him lay down on his back, legs parted, allowed for stimulation of his testicles and gentle engagement of his penis that caused unyielding erections, wiggling of the buttocks and wide eyed stares. Within minutes of doing this, one could easily induce them to produce a semen sample. Most would start to leak and moan as stimulation was applied to his shaft and rubbing of testicles. Some would announce that he was going to “cum” while others lifted their butt cheeks off the table and gasped as the moment arrived.

About half to two thirds would ejaculate within minutes of this process. For those who did not, the introduction of a finger into his rectum resulted in immediate ejaculation.

With the successful gathering of a semen sample, the exam concluded but not before each received a gamma globulin inoculation along with a mandatory tetanus shot; each provided in the buttocks. This required the nurse to return, perhaps adding insult to eventual injury.

When done, most seemed to need time to recover before dressing. Some looked sad while others just appeared to be shocked by the process. All were clearly drained both physically and emotionally by their exams.

Providing these exams surely made me recall my own experiences as well as relish in being able to control the experiences being provided. I suspect many now recall having to get their First Developmental Exam. I know I sure did!