During my consultations, when we get to the genital examination, I like the patient to first lower their underwear and expose their genitals.
I then observe their general condition, both front and back.
Once this is done, I move on to examining the genital area: pubic hair, general condition of the penis and testicles. We then check to see if there are any inguinal hernias that need to be treated.
Once this is done, we will take hold of the penis and, if it is not circumcised, we will see how it retracts, check for any problems with phimosis or paraphimosis, observe the urethra, palpate the penis, and take a sample with a swab. I also like the patient to provide a urine sample in our presence so that we can see how they urinate.
Then we will move on to the back, first with an external examination and then moving on to the invasive part. First, with the patient standing, I lubricate the area well and insert a finger to see how his anus is and if he needs an enema.
If necessary, we will give him one or more enemas to clean the area and then proceed to the insertion and palpation of the prostate.
If necessary, we will proceed with the insertion of an anoscope to get a good view of the anal area.
Finally, we will ask the patient for a semen sample to check his erection and the amount he ejaculates.
If necessary, we can perform further tests such as stimulation assisted by the medical team, with or without the insertion of devices or the use of electrostimulation or similar techniques.
Throughout the process, we will ask the patient questions about their genitals, sexual habits, etc.
Once all the tests have been completed, I like to sit down with the patient to explain the findings and whether any other tests or procedures are necessary.