Conduction of palpation of testicles in the doctor and self-diagnosis

Problems of urological and andrological profile suggest carrying out palpation( physical) examination of the organs of the scrotum. The time for palpation occurs immediately after the completion of the history of the patient's history and oral questioning. By that time, the specialist has time to put in his head an approximate clinical picture. The physical study is designed to solve several important tasks :

• Evaluate the size of the anatomical structures( primarily the testicles).
• Determine the density of testicles.
• Evaluate the structure of the testicles.

Indications

The main indication for the reduction of the study is the presence of pain syndrome in the groin area of ​​any intensity. In general, the manipulation is carried out at any visit to the andrologist or urologist. There is no clear list of indications. This method is almost the same as the visual assessment for the initial diagnosis.

Physical examination does not give 100% results. However, it provides an opportunity for the doctor to determine the tactics of further examination. First of all, it is possible to identify the following pathological conditions :

Orchitis - inflammation of the testicular tissues

• Cryptorchidism( more) .Non-admission of testicles from the retroperitoneal region to the scrotum. With palpation, everything becomes obvious. One or both testicles absent. The scrotum is flattened and atrophied to the touch. The asymmetry is determined visually. With a deeper feeling, the testicle can be detected. As a rule, physical examination plays a huge role in the preoperative period, as it allows to detect the testicle.
• Orchitis( more details) .Inflammation of the testicle. During palpation, the doctor discovers areas of increased soreness. The testicle itself becomes denser, even hard. The mobility of testicles is sharply reduced. When trying to move the testicle from its place, there is a pronounced pain syndrome. Torsion of the testis .To make the diagnosis, the so-called Pren symptom is revealed. When trying to dislodge the testicle from a normal position, the pain increases sharply. In addition, the feeling of the organ reveals the rotation of the appendage when it moves anteriorly from its natural position. This testifies to the presence of torsion.
• Cancer and other neoplasms of the testicles( more) .When the scrotum is felt, nodal seals are found in the structure. It is important to determine their character and clearly record the following signs: mobility, tenderness, density. So, solid tumors are characterized by a homogeneous structure. When palpation, such formations are defined as dense fixed nodes. Solid-cystic formations are less dense, more mobile.
• 

  Hydrocele( edema of the testicle) is a pathology characterized by the accumulation of fluid in the scrotum

  Epididymitis .Inflammation of the epididymis. It is important to conduct differential diagnosis with orchitis. When palpation, the affected testicle, as a rule, is higher than the healthy one. In addition, when the testicle is displaced, the pain syndrome becomes less intense( positive Pren symptom).

• Hydrostsel .Dropsy testicles. When palpating, swelling of the scrotum and genital organs is detected. It turns out to be puffy, excessively soft. Pathognomonic sign of the disease also exists. When pressing on the testicle, the opposite side of the scrotum thickens significantly. This indicates the accumulation of fluid in the body cavity.
• Varicocele .Often does not require even palpation. But this is true only for the late stages of the disease. In the initial stages, the physician, through physical examination, can detect excessively inflated veins( they are easily probed).

Evaluation criteria

In conducting this survey, the doctor draws attention to the following testicular characteristics of :

• Dimensions of .Normally, the testes should be almost the same size. The significant difference between testicles is a cause for concern. It can be about orchitis and other inflammatory pathologies( see "Are the size of the testicles important in men?").
• Consistency of .The testicles are moderately dense, elastic. Too hard testicles testify in favor of the same orchitis. If the softness of the scrotum is excessive, there is reason to suppose dropsy.
• Location .Are on the same level. Spontaneous ascent, as well as ovulation of the testicle, can be the result of torsion, epididymitis. Also, we can talk about false cryptorchidism( an excessively mobile structure).
• Presence / absence of nodal formations .The presence in the structure of the scrotum of tumor-like neoplasms is an absolute indication for urgent instrumental examination.
• The first thing that a doctor should pay attention to, paradoxically, is whether both testicles are in the scrotum. In the absence of one of the testicles, a slight pressure is applied to the abdominal cavity( lower abdomen) in order to return the testicle to its place. With , the false cryptorchidism of is triggered. Otherwise, if there has not been an operation to remove the testicle, there is every reason to suspect a true cryptorchidism.

All specified characteristics are fixed without fail. They have great diagnostic value.

Methodology for conducting

No special training is required from the patient. It is enough to conduct standard hygiene measures. Palpation is carried out in several stages :

All research takes, on average, about 3-5 minutes

1. The doctor conducts hygienic treatment of hands or puts on gloves.
2. The patient assumes a standing position.
3. The doctor approaches the patient. A frontal position( in front of the patient) is permissible. However, it is much more convenient to be on the side of the subject. For convenience, the doctor can kneel.
4. First, a visual assessment of the anatomical structures of the reproductive system is carried out.
5. The penis is set aside( you can ask the patient to do this).
6. Now it is necessary to probe each testicle separately. With one hand, the doctor holds the scrotum. With the index finger and thumb of the other hand, the testicle palpates all over the volume. Then you should go higher and assess the condition of the epididymis, the spermatic cord.
7. When a tumor is detected, a detailed evaluation of the neoplasm is mandatory.

Self-examination capabilities

Knowing the technique of performing palpation, a man can resort to manipulation and independently. A physical examination is carried out in the same way. However, due to the lack of special knowledge, it will be difficult to decipher the results. It is enough to bear in mind two points:

• Any nodal inclusions in the structure of the scrotum are abnormal. If they are present or if there are doubts, you should urgently consult a doctor.
• Normally, when palpation pain should not be. Pain syndrome is evidence in favor of the course of any pathological process. With pain also need to go to the doctor.

See also: Egg massage: why and how to perform it?

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