A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height [increasing obesity in adulthood, which is most evident on the trunk (so-called truncal adiposity)]; furthermore:
- Inspection (observation) [tall stature with large hands/feet but small head; lack of typical male hairiness].
- Skin and mucous membranes
- Physique
- Inspection and palpation (palpation) of the mammae (mammary glands) [gynecomastia/enlargement of the mammary gland in men].
- Inspection and palpation of the abdomen (stomach), inguinal region (groin region), etc. (pressure pain?, knock pain?, release pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection and palpation of the genitals (penis and scrotum); assessment of:
- Pubescence (pubic hair) [absence of typical male hair].
- Penis (penile length: between 7-10 cm when flaccid; presence of: Indurations (tissue hardening), anomalies, phimosis / foreskin constriction?) [small penis* ]
- Testicular position and size (if necessary by orchimeter) [small hardened testicles / testicular volume: 2-3 ml; differential diagnosis: condition after bilateral cryptorchidism (absent testicles in the scrotum; abdominal testicles)]
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation (assessment of the prostate in size, shape and consistency, possibly detection of indurations (tissue hardening)).
- Inspection (observation) [tall stature with large hands/feet but small head; lack of typical male hairiness].
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
* penis length
- By definition, a micropenis (small penis) is present when it measures no more than 7.5 cm in length when erect.
- The average penis length of the German male is 14.6 cm (± 2, 5) in the erect state.