It’s about more than just the penis
A “penis exam” is more involved than you might think. Doctors know it as a genitourinary (GU) and rectal exam, which involves your:
- penis head (glans) and shaft
- scrotum and testicles
- anus and rectum
Let’s go over what’s involved, why you should get it done regularly, what you should look out for during self-exams, and more.
Why is examining your Penis and Testicles important?
Genital exams keep you intimately aware of how the entire area typically looks and feels.
Having a baseline is key to identifying changes as they happen and seeking out appropriate diagnostic tests sooner rather than later.
In many cases, early detection allows your doctor to develop a treatment plan for cysts, growths, and other abnormalities before more serious complications can occur.
What conditions do genital exams screen for?
Genital exams most commonly screen for the following conditions:
- hernia, when intestines push through muscle into the groin area
- urinary tract infections (UTIs)
- benign prostatic hyperplasia (BPH)
- erectile dysfunction (ED)
- Peyronie’s disease
- penile or scrotal tissue damage caused by diabetes or high cholesterol
- damage to the blood vessels
- prostate cancer
- penile cancer
- testicular cancer
When should you start doing self-exams and getting clinical exams?
If you develop a genital or rectal condition at a young age, your doctor may ask you to start doing genital self-exams.
Otherwise, you probably won’t need to do self-exams until you begin going through puberty.
Your doctor may also start performing genital exams at this time — if they aren’t already — as part of your annual physical.
How do you do a self-exam?
General guidelines suggest:
- Make sure your genitals are relaxed. This keeps the tissues loose so that you can easily feel around.
- Lightly pinch the top of your scrotum to keep your testicles in place.
- Gently move your fingers and thumb along the entire surface of each testicle. Feel for lumps or hard tissue. They can be as small as rice grains or as large as grapes. Don’t worry about that lump on the back of your testicle, though — that’s the epididymis.
- Now, gently run your fingers along your penis shaft and head. Look for lesions or tissue damage. Squeeze lightly to check for any lumps, firmness, or tender areas. If you have a foreskin, move it back to look and feel underneath there, too.
No lumps, bumps, or tissue issues? No need to take any action.
Found something new or unexpected? See a doctor as soon as possible.
The earlier you find a potential issue, the less likely you are to experience complications in the long run.
How often should you do a self-exam?
Do a self-exam at least once a month to stay on top of any noticeable changes and become more familiar with your genital area.
The more intimately you know your penis, scrotum, and testicles, the more sensitive you’ll become to slight changes that could be worth reporting to a doctor.
If you’re performing regular self-exams, do you still need to get a clinical exam done?
Yes! Your doctor is trained to recognize numerous signs and symptoms of genital, urinary, and rectal conditions.
Your doctor also has significant training in diagnosing and treating these kinds of conditions.
This means that they can provide immediate recommendations for treatment or refer you to specialists to ensure that you receive any necessary care.
What type of doctor do you see for a clinical exam?
A general practitioner (GP) or primary care physician (PCP) can do physical examinations, which usually include basic genital exams.
If a genital exam isn’t included, request that your GP or PCP do one for you.
If you feel uncomfortable asking for or receiving this exam, talk to a doctor about the self-examination process.
They can ensure that you’re using the correct method to monitor for changes at home.
If needed, your GP or PCP can refer you to a urologist for specialized diagnosis and treatment.
Urologists are specifically trained in penile, testicular, and genital health, so they can offer individualized information about treatment and prevention.
What does a clinical exam consist of?
Depending on your medical history, your doctor may perform one or more of the following exams:
- Physical exam. Your doctor will ask you questions about your medical history and lifestyle during this exam. They’ll also check your height, weight, and pulse; and examine your entire body, including your genitals, for growths or abnormalities by lightly feeling the genital, groin, and anal areas.
- Mental health exam. Your doctor will look at your body language and response to social cues, such as eye contact; ask you basic questions about your name, age, and where you live; and use short tests to check your attention span, memory, language, and judgement abilities.
- Blood and urine (laboratory) tests. Your doctor will take a small sample of your blood using a needle and test tube, and ask you to pee in a small sample cup (in privacy, of course). Some doctors do this on site, but you may be sent to a separate lab facility that can do the testing.
- Doppler ultrasound imaging. During this test, your doctor will use a lubricating jelly and device called a transducer to send sound waves into your body and return images to a screen. This can help your doctor look closely at any abnormalities and determine if they’re benign, cancerous, or a sign of another condition. This test can also be used to check how well blood flows through your penile arteries and veins.
- Injection test. Your doctor may recommend this test if you’re experiencing signs of ED. Your doctor will inject a chemical into your penile shaft to induce an erection so that they can examine how hard you get and how long you stay hard.
- Overnight erection test. Your doctor may recommend this test if you have ED. They’ll give you a ring to slide onto your penis at night. If you wake up to a broken ring, it means you’ve had an erection — and that the underlying ED cause is likely psychological. Some ring tests are digital, so they collect physiological data that can be stored electronically and analyzed later.
Do you need to be erect for a clinical exam?
You don’t, but it may happen unintentionally — and that’s completely normal.
Your penis is full of sensitive nerves and erogenous zones that are meant to help you get erect, so it isn’t unusual for an erection to occur while your doctor is physically examining the area.
Your doctor has probably seen this happen hundreds or thousands of times, so they shouldn’t be fazed.
Will it include a prostate exam?
If you’re age 55 or older, you may already be getting annual prostate exams.
Otherwise, your doctor likely won’t recommend this exam unless they observe unusual symptoms that could be related to your prostate.
A prostate exam is actually composed of two different tests: the digital rectal exam and the prostate-specific antigen (PSA) exam. Here’s how they’re done.
Digital rectal exam
- You’ll bend over at your waist or lie on your side with your knees up at your chest.
- Your doctor will put on lubricated rubber gloves and gently insert a finger into your rectum.
- Your doctor will gently press on your prostate to check its size and shape while pressing on your pelvic area with the other hand. It’s totally normal for this to feel a little uncomfortable or to suddenly have the urge to pee.
This is a blood test. Your doctor will take a sample of your blood and send it to a lab to test for PSA.
Here’s what PSA results are read:
- Normal: less than 4 nanograms per milliliter (ng/mL)
- Intermediate: 4 to 10 ng/mL
- High: more than 10 ng/mL
The PSA test is somewhat controversial, so your doctor won’t use it to diagnose anything without taking the results of other tests into consideration.
How often should you get a clinical exam?
Get a clinical genital exam at least once a year. Basic genital exams that involve checking your genital appearance and lightly feeling around the area are typically done during routine or annual physicals.
You can request that your doctor do more specific or detailed tests if you’re concerned about any changes you’ve noticed in your genitals.
What happens after a clinical exam?
Your next steps will depend on what, if any, symptoms your doctor observed during the clinical exam.
Here are some possibilities:
- You’re referred to a urologist or other specialist for specialized testing and diagnosis.
- You get further testing done to diagnose conditions that may be causing genital abnormalities or growths.
- You’re prescribed medication that can relieve symptoms of genital abnormalities or dysfunction.
- You’re referred to a therapist or counselor if the cause of your genital abnormalities is psychological or emotional.
The bottom line
Genital exams are an important part of ensuring your overall health.
You can do self-exams at home, but you should also get formal genital exams done as part of your annual check-up.
Your doctor can diagnose anything new you may have noticed, catch anything that you may not have observed, or use follow-up tests to determine whether these changes indicate an underlying condition.
- Genital exam — male (pre- or early puberty). (2017).
- Male GU exam. (n.d.).
- Mayo Clinic Staff. (2019). PSA test.
- Testicular self-exam. (n.d.).
- Tests for penile cancer. (2018).