Obtain consent, ensure privacy, and have a chaperone present per agency policy before beginning the examination.
Assess voiding by history and, where ordered, measure the post-void residual to evaluate emptying and retention.
Palpate the suprapubic area for bladder distension where retention is suspected (bladder detail in Urinary/Renal).
Inspect and gently palpate the scrotum and testes for swelling, masses, and tenderness, and note testicular lie; acute severe testicular pain is a surgical emergency.
Assess the inguinal regions for a hernia and determine whether it is reducible or irreducible and tender.
Inspect a post-operative site or catheter for bleeding, infection, and patency, and assess drainage.
Inspect the genital and perineal skin for the signs of a necrotizing infection — disproportionate pain, discoloration, crepitus, and systemic toxicity — and escalate immediately if present.
For acute severe testicular pain, acute retention, an incarcerated hernia, or signs of a necrotizing infection, escalate rather than continuing the exam.
