Penis

Inspection:

• size and shape of penis
• colour of skin
• presence or absence of foreskin
• any discharge
• scabbing or scaling around the distal edge of penis
• look at ventral surface of penis - may reveal hypospadias

Palpation:

• palpate the whole length or the body of the penis
• palpate the length of the urethra down to the perineal surface
• note the state of the dorsal vein - palpate pulses on dorsal surface if indicated
• retract the prepuce to examine its inner aspect, the external urethral meatus and the glans penis. If any discharge then take bacteriological swab

It is not possible to examine structures under the prepuce in a young child. The prepuce and glans foreskin are tethered together at birth, and only separate slowly during the first few years of life because of the secretion of smegma into the coronal sinus.

In later life, adhesions may prevent retraction of the prepuce. They must be surgically divided if the glans penis is to be examined. If the patient has a tight phimosis, a dorsal slit or circumcision may be required to allow proper examination. It is important to examine under the prepuce if suspected carcinoma is to be excluded.