VENEREOLOGICAL EXAMINATION

IN

MALE
I. GENERAL OBJECTIVE

After completing a skill practice of venereological examination in male, the students will be
able to perform venereological examination in male patient.

II. SPECIFIC OBJECTIVE

At the end of skill practice, the student will be able to demonstrate the venereological
examination in male patient.

III. METHOD
• Presentation
• Coaching
• Self practice on anatomical model
IV. EQUIPMENT

- PRESENTATION

- Audiovisual aids

- COACHING & SELF PRACTICE ON ANATOMICAL MODEL

Room:
- Examination room (closed curtain, closed door)
- Examination bed
- Examination chair
- Lamp
- Sink
- Medical waste bin

Patient:
- Anatomical model (male genitalia)
- Informed consent form
- Pen

Tools:
- Head lamp/ spotlights
- Gloves (size S, M, L)
- Sterile gauze
- Cotton stick for specimen collection
- Transport media for Neisseria gonorrhoeae (N. gonorrhoeae) and
Chlamydia trachomatis (C. trachomatis)
- Normal saline (wet preparation)
- Object glass and cover glass
- Magnifying glass
- Emesis basin
- Glass tube rack (1)

Examiner:
- A male or female nurse may stay in the room during the examination.

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LEARNING GUIDE VENEREOLOGICAL EXAMINATION PROCEDURE IN MALE

N STE 0 1 2 Commen
o. P t
Client Assessment
01 Greet patient kindly and respectfully.
. The patient should be given adequate explanation
about the examination.
02 Asked patient to sign informed consent before
. conducting the examination.
03 A male or female nurse may stay in the room
. during the examination.
04 Asked patient to refrain from voiding 3 hours prior
. examination.
Abdominal Examination
05 The patient is asked to lie supine or lythotomy
.
06 Stand at the right side of the bed.
.
07 The examiner inspect the suprapubic, if there is
. any suprapubic bulge.
08 Wash your hands and dry with clean dry towel,
. then
put the gloves on for both hands.
09 Palpate the suprapubic to determine a distended
. bladder.
Groin and Pubic
10 The examiner stand in front of patient.
.
11 Inspect and palpate the inguinal region for the
. presence of lymphadenopathy.
Note the number, size, consistency, mobility, and
tenderness if any.
12 Inspect the pubic skin for redness and pubic hair
. for lice and nits.
Penis. Examiner sit in front of patient
13 Inspect the shaft of the penis for any skin lesions
. such as erosion, ulcer, papule, or vesicle, and
Peyronie’s disease.
14 Palpate the shaft of the penis, looking for firm
. fibrotic plaques (characteristic of
Peyronie’s
disease).
15 In uncircumcised patient, the foreskin should be
. retracted and inspect for skin lesions, balanitis,

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posthitis, or tumor.

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16 Inspect the external meatus of the urethra for
. erythema, edema, or redness.
If there is discharge on external meatus of the
urethra, note the amount, color, and consistency.
If there is no discharge, the urethra should be
massaged gently from the root of the penis to the
meatus.
17 The urethral meatus is examined by pinching the
. glans between the thumb and the forefinger at the
6 and 12 o’clock positions to exclude presence of
meatal stenosis, intraurethral lesions such as
ulcers, papules, or other skin lesions, and
congenital
anomaly (hypospadias or epispadias).
Specimen collection
18 Inform the patient that the specimen will be taken
. from orifice genital. The examinder instruct the
patient to relax.
19 Clean the meatus with a sterile gauze damped in
. NaCl 0.9% to ensure an uncontaminated sample.
20 Neisseria gonorrhoeae:
.
The sample is taken by using cotton tipped.

● First specimen for culture, insert a sterile

cotton tipped 2–3 cm into the urethra, rotate
for 5–10 seconds, and placed in N.
gonorrhoeae transport media.
● Second specimen for Gram-stained smear,
insert a cotton tipped 2–3 cm into the urethra,
rotate for 5–10
seconds, and rolled onto object glass for a
Gram- stained smear.
21 Chlamydia trachomatis:
.
Insert the cotton stick 2–3 cm into the urethra then
gently scrape the mucosa by rotating the swab for
5–
10 seconds, and placed into the transport media for
PCR examination.
22 Trichomonas vaginalis:
.
Insert the cotton stick 2–3 cm into urethra. Mix it
with a drop of saline on the object glass and cover
with cover glass.

The sample should be examined under

microscope no more than 10 minutes for optimum
sensitivity

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 Scrotum
23 Inspect the scrotal skin for any lesion such as
. sebaceous cyst or angiokeratoma.
The scrotum isn’t symmetrical, the left side is
lower than the right side.
Testis

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24 Each testis should be palpated using two hands for
. the size, tenderness, induration, or solid mass
lesion.
25 Transillumination of all scrotal masses should be
. routine.

The patient is placed in a dark room and a strong

light is applied to the back of the scrotum. Light is
transmitted well through benign cystic structures,
such as hydroceles or spermatoceles, but not
through
solid mass lesions, such as testicular tumors.
Epididymis
26 Palpate the epididymis carefully for the size,
. induration, and tenderness. Feel the groove
between the testis and the epididymis everywhere
except superiorly, where the two structures are
joined. During acute infections, the testis and
epididymis are
often indistinguishable, as both structures are
involved in the inflammatory process.
Spermatic cord
27 Palpate the spermatic cord on both side using
. thumb
and index finger. Any tenderness, thickening or
asymmetry should be noted.
Perianal
28 Inspect the perianal for the presence of lesions
. such as warts, vesicles, erosion, ulcers, or other
lesions and discharge.
If there is discharge, note the amount, color, and
consistency
Hernia
29 Asked patient to stand and examined the presence
. of hernia.
Insert the index finger through the neck of the
scrotal following the spermatic cord until external
inguinal ring. If hernia is present, the mass could
be felt on
the fingertip.
30 Tell the patient that the examination is done and
. the patient can put his clothes back on and wait for
the result in the waiting room.