The male reproductive system and hernias
The male external genitalia comprise the penis, scrotum and scrotal contents. The most common penile condition is phimosis, which may be caused by, and predispose to, infection, and may cause pain on erection and difficulty with micturition. The cremasteric fascia is muscular, and contraction of this muscle may cause the testicles to retract into the groins, especially in children. This may lead to a mistaken diagnosis of undescended testicle. Adult hydrocoeles and epididymal cysts develop over months to years and present as painless scrotal swellings. The patient is concerned either that the swelling may be sinister or by the inconvenience it causes. Palpation of the penis may identify areas of fibrosis in the shaft in Peyronie’s disease, but is of little value in most conditions. Palpation of the scrotal contents aims to identify the normal structures and the relationship of any abnormality to these. Using both hands, each testicle is picked up in turn.