Chapter 20: Male Genitalia

Male Genitalia educational resource explores the clinical assessment of the male genitalia and inguinal region, providing a foundation in both anatomical structures and physiological functions. The discussion begins with a detailed overview of external anatomy, covering the penis, scrotum, and the internal components of the spermatic cord and testicular structures. It examines the hormonal interplay of the hypothalamic-pituitary-gonadal axis, specifically the roles of testosterone and gonadotropins in male development, alongside the neurovascular mechanisms driving sexual response. For the clinical encounter, the material emphasizes professional communication strategies for gathering a sensitive sexual history and identifies concerning symptoms such as penile discharge, lesions, or scrotal discomfort. A significant portion of the chapter is dedicated to the physical examination, outlining systematic techniques for inspecting and palpating the genitalia to detect abnormalities like phimosis, balanitis, or Peyronie disease. Students will learn to distinguish between various scrotal masses, utilizing diagnostic aids like transillumination to differentiate between fluid-filled hydroceles and solid tumors. The text provides a rigorous framework for identifying and classifying inguinal and femoral hernias based on their anatomical landmarks and clinical presentation. Furthermore, it details common sexually transmitted infections, including the appearance and causative agents of syphilis, herpes, and human papillomavirus. Finally, the chapter addresses preventive health, offering guidance on testicular self-examination and reviewing evidence-based screening recommendations for testicular cancer to enhance patient education and early detection.