For those of you who do male exams, how is the required semen extraction performed? What happens to the semen?
OK, I'll start it out. I generally use one of a few methods. First off, as so many others have mentioned, I too perform it as the last item on the exam. The reason is that I believe my patients anticipate it, and with that in mind, the most semen will be produced by the end of the exam. I have at hand a small collection cup, large enough for the ejaculation. I generally give my patient the simple choice of how he'd like it done, i.e., by my doing it for him, or by him masturbating into the cup. Most, frankly, prefer I do it.
I usually lubricate my hand and fingers (no glove) and try to simulate the way he does it himself. I find that out by simply discussing it with him. My other hand has the cup ready, into which he'll ejaculate. I've tried having him hold the cup, but there have been too many accidents.
Another way is that I use a lubed vibrator on his penis and have him ejaculate that way. One fellow who comes in quarterly would have it no other way, after I'd introduced him to it.
The third way is more elaborate and somewhat rare, because my patients seem to prefer other methods. I'll gently insert in appropriately sized sound, well into his urethra, continuing into his bladder. I'll position it where I know his prostate is and move it around that area while I lightly masturbate him. Sometimes, I'll also hold a vibrator to the protruding end of the sound. That's generally so erotic and stimulating to the patient that he'll ejaculate very quickly that way, most times in under two minutes. I generally do remove the sound immediately prior to that. I use that method primarily on older patients, high 50s on up.
I sometimes combine massaging the patient's prostate while he's masturbating, or while I'm masturbating him. In that case, he needs to hold the collection cup.
After I have my sample, I pour it from the sample cup into a small, graduated cup which has metric measurements on it. I check the semen for color, clarity quality, and viscosity, kinda like a fine diamond! Then I look at the side of measuring cup to determine quantity in ml. Then, that all goes into the notes I keep for each patient.