| Skill 3-9 | Assessing the Male Genitalia | ||||||||||||||||||||
The external male genitalia (Figure 1) include the penis and scrotum. In addition, the inguinal area may be assessed as part of this assessment. During the physical assessment, the nurse examines the external genitalia by inspection and palpation, and the inguinal area by inspection. Examination of the prostate gland is a skill performed by an advanced practice professional. The American Cancer Society (ACS, 2018) advises men to be aware of testicular cancer and to see a health care provider right away if they find a lump in a testicle. Routine testicular self-exams can give a patient greater awareness of the condition of their testicles and help detect changes (Mayo Clinic, 2018). Delegation Considerations The assessment of the patient's genitalia should not be delegated to assistive personnel (AP). However, the AP may notice some items while providing care. The nurse must then validate, analyze, document, communicate, and act on these findings, as appropriate. Depending on the state's nurse practice act and the organization's policies and procedures, the licensed practical/vocational nurses (LPN/LVNs) may perform some or all the parts of assessment of the patient's genitalia. The decision to delegate must be based on careful analysis of the patient's needs and circumstances as well as the qualifications of the person to whom the task is being delegated. Refer to the Delegation Guidelines in Appendix A. Assessment Complete a health history, focusing on the male genitalia. Identify risk factors for altered health by asking about the following:
Actual or Potential Health Problems and Needs Many actual or potential health problems or needs may require the use of this skill as part of related interventions. An appropriate health problem or need may include: Outcome Identification and Planning The expected outcome to achieve in performing an examination of the male genitalia is that the assessments are completed without causing the patient to experience anxiety or discomfort, the findings are documented, and the appropriate referral is made to other health care professionals, as needed, for further evaluation. Other outcomes may be appropriate, depending on the specific diagnosis or patient problem identified for the patient. Implementation
Evaluation The expected outcomes have been met when the patient has participated in the assessment of the genitalia; the patient has verbalized understanding of the assessment techniques as appropriate; the assessment has been completed without the patient experiencing anxiety or discomfort; the findings have been documented; and the appropriate referrals have been made to the other health care professionals, as needed, for further evaluation. Documentation Guidelines Document assessment techniques performed, along with specific findings. Note and record the size, placement, contour, appearance of the skin, presence of foreskin, redness, edema, location of urinary meatus, and discharge. Document any patient statements of pain and risk factors. Sample Documentation 09/23/25 1730 Patient denies pain and discharge from penis; denies lumps or changes in scrotum. Patient reports no difficulty with urination. Scrotum of equal size and shape. Skin without lesions, edema, redness; foreskin present and intact, uniform in color, and easily retracted. Urinary meatus located in the center of the glans penis and is free of discharge. Scrotum and testes free of masses and nontender. Inguinal area is free of bulges.Developing Clinical Reasoning and Clinical Judgment Special Considerations Infant and Child Considerations
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1. Perform hand hygiene and put on PPE, if indicated.
2. Identify the patient.