Genito-Urological Examination
From Encyclopedia of Sex and Sexuality
A genito-urological examination is usually performed as part of a general medical examination or separately by a urologist, when it seems prudent to check for any abnormality or disease that may affect the genito-urinary system. Urologists generally specialize in genital examinations of men and examinations of urinary systems in both men and women, while gynecologists specialize in genital examinations of women, usually carried out during pelvic examinations. Reproductive or fertility disorders are generally evaluated by urologists for men and by gynecologists for women, sometimes in association with an endocrinologist (hormone specialist). Some urologists and gynecologists are trained in a “couple-oriented” approach to the evaluation of infertility.
The genito-urological examination usually begins with inspection of the abdomen for abnormal masses or appearance and by stethoscope for abnormal bowel sounds. Then, the examining physician places hands on the abdomen to examine the internal organs. On the upper right side, underneath the rib cage, the kidneys may be examined by placing a hand on the patient’s lower back and moving the kidneys forward. The bladder area is similarly inspected and then palpated (felt by the physician’s hands). Groin areas are examined for the presence of hernias.
The male’s examination continues with visual inspection of the penis for sores on the skin and palpation of the penis for any lumps or irregularities on its surface. The scrotum is examined to detect the presence and size of the testicles as well as their consistency. Examination of the testicles is important to detect any hard areas or masses that might suggest the presence of cancer or a tumor in the testicles. The epididymis (area around the testicles) is also examined, as is the vas deferens, which carries sperm from the testicles to the ejaculatory area.
At this point the examining urologist will usually have the patient stand. For men a finger is placed along the cord carrying the blood vessels to the testicles into the region of the groin where hernias may occur. The patient will usually be asked to cough or bear down to detect the presence of hernias. The cord of blood vessels going to the testicles will also be examined to detect the presence of a varicoele (an enlargement of veins within the scrotum) that may affect the function of the testicles and fertility.
The urological examination also includes an examination of the rectum with a lubricated, gloved finger. This allows the physician to gain important information about the size and consistency of the prostate, as well as any other abnormalities in the rectum, such as tumors.
In women the urological examination includes an external examination of the vulva. Usually, the physician will separate the labia to examine the outer portion of the urethra (urine passage). The physician will generally perform an internal pelvic examination.
