Urologic physical examination

The examination should be guided by the medical history.

General assessment

Observe:

• general condition;
• temperature;
• blood pressure;
• hydration;
• pallor;
• edema.

Abdomen and flank region

Look for:

• pain;
• masses;
• distension;
• scars;
• bladder distension.

Costovertebral angle percussion may elicit pain in certain renal or infectious processes, although it is a nonspecific finding.

Male external genitalia

Evaluate:

• penis;
• urethral meatus;
• foreskin;
• scrotum;
• testicles;
• epididymides;
• spermatic cords.

Assess:

• size;
• position;
• consistency;
• pain;
• masses;
• skin lesions.

Digital rectal exam

It allows partial assessment of:

• prostate size;
• symmetry;
• consistency;
• surface;
• presence of nodules;
• pain.

An enlarged, smooth, symmetric, firm-elastic prostate may be consistent with benign enlargement.

A hard, irregular, or nodular prostate requires further evaluation.