Palpation

Palpation Genitals

Palpate each testis and epididymis between your thumb and first two fingers.

Note size, shape, consistency, and tenderness; feel for any nodules. Pressure on the testis normally produces a deep visceral pain.

See Table 10-2, Abnormalities of the Male Genitalia (pp. 379-380).

Rashes, epidermoid cysts, rarely skin cancer

A poorly developed scrotum on one or both sides suggests cryptorchidism (an undescended testicle). Common scrotal swellings include indirect inguinal hernias, hydroceles, and scrotal edema. Tender, painful scrotal swelling in acute epididymitis, acute orchitis, torsion of the spermatic cord, or a strangulated inguinal hernia.

Any painless nodule in the testis must raise the possibility of testicular cancer, a potentially curable cancer with a peak incidence between the ages of 15 and 35 years.

Palpate each spermatic cord, including the vas deferens, between your thumb and fingers from the epididymis to the superficial inguinal ring.

Note any nodules or swellings.

Palpate each spermatic cord, including the vas deferens, between your thumb and fingers from the epididymis to the superficial inguinal ring.

Note any nodules or swellings.

Multiple tortuous veins in this area, usually on the left, may be palpable and even visible. They indicate a varicocele (p. 380).

The vas deferens, if chronically infected, may feel thickened or beaded. A cystic structure in the spermatic cord suggests a hydrocele of the cord.

Swelling in the scrotum other than the testicles can be evaluated by transillumination. After darkening the room, shine the beam of a strong flashlight from behind the scrotum through the mass. Look for transmission of the light as a red glow.

Swellings containing serous fluid, as in hydroceles, light up with a red glow, or transillumi-nate. Those containing blood or tissue, such as a normal testis, a tumor, or most hernias, do not.

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