Hey, good afternoon. I'll be performing a comprehensive pelvic exam on you. It's pretty important for guys to get checked regularly. Boys in particular might be in pain and they'll just hope it goes away on its own. I think most of them are scared of being naked in front of the doctor. They're scared of the doctor's measuring tape. That's just a working theory.
The exam will include an external assessment of your abdomen and genitals, and an internal assessment of the rectum. You can ask me to stop or pause at any time if you feel uncomfortable with me touching you or having a look at you. Have you had a pelvic exam before? Thank you for telling me. Let me put on my gloves and I'll explain what's going to happen.
First, I'll ask you to pull down your pants for me so I can have a look at your external genitalia… inspecting your foreskin, seeing if you can roll it back without any pain or discomfort, checking for cleanliness. I'll be touching the skin of your penis, including the glans, and your scrotum, just looking for dryness or discolouration, or discharge, lumps and bumps. You'll feel me wipe pre-cum from the tip of your penis with my gloved finger or a tissue.
Examining the testicles does involve palpating the entire testicle, identifying the spermatic cord with my fingers and thumbs making sure there are no serious masses anywhere. I'll be as gentle as possible but a lot of boys are pretty sensitive down there and you'll feel me tugging and pulling. I'll do both testicles like that while you stand, and then I'll have you lie down for me and I'll re-check them the same way. I'll also dim the lights, put my pen-light right under your scrotum, and look for any fluid sacs.
Just so you're not surprised I will be asking you about your sexual activity… your girlfriends or boyfriends, if you're using condoms, your masturbation habits. Please tell me the truth, as I will want to test for STIs, and you either have guys pretending they're virgins to avoid me checking or guys that are lying and getting a couple of these bad boys about that far down inside their urethras because they're too embarrassed to stop me from taking swabs. I'll ask if you have any trouble with achieving erection, if you experience painful ejaculation… if you experience premature ejaculation. A lot of boys your age being examined for the first time by me, right where you're standing. You get the picture. But it's completely normal. Doctors are very used to it.
And as I mentioned, after I have a look at the perineum and anus I'll perform a digital rectal exam and assess the prostate. This is done with a gloved finger and plenty of lube. You don't have to consent to this right now, we can check in on how you're feeling when we get to that part of the examination… but 100% of my patients end up begging me for it. The last part I'll do is urinalysis.
Do you have any questions for me? Do I have your permission to touch you? Okay, go ahead and drop your pants and let's see what we're working with.
