A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
- Inspection (viewing) and palpation (palpation) of abdomen (stomach), inguinal region (groin region), etc. (tenderness?, tapping pain?, release pain?, coughing pain?, guarding pain?, hernial orifices?, kidney bearing tapping pain?)
- Inspection and palpation of the genitals.
- Penis and scrotum (scrotum); assessment of pubes hair (pubic hair), penis (penis length: in flaccid state between 7-10 cm; presence of: Indurations (tissue hardening), anomalies, phimosis/foreskin stenosis?)
- Testicular position and size (if necessary by orchimeter): examination of both testicles (side difference or swelling?) [To differentiate between acute epididymitis (epididymitis) and testicular torsion, the Prehn’s sign is checked: in the case of epididymitis, the symptoms improve when the testicle is lifted; in the case of testicular torsion, the pain persists; if necessary. Establishment of the following differential diagnoses: Hydatid torsion – twisting of the appendix testis (Morgagni hydatid), the symptomatology corresponds to testicular torsion; hydrocele (hydrocele) – congestion of fluid in the tunica vaginalis testis (testicular sheath); orchitis (testicular inflammation) – usually caused by viruses, less frequently by bacteria; as mumps orchitis usually 4-7 days after parotitis (inflammation of the parotid gland); spermatocele (seminal hernia) – a retention cyst (cyst formed due to obstruction of drainage) usually located on the epididymis, containing fluid containing semen; varicocele (synonyms: Varicocele testis; varicocele hernia) – varicose vein formation in the area of the pampiniform plexus formed by the testicular and epididymal veins, a plexus of veins in the spermatic cord; in a high percentage (75-90%), varicocele occurs on the left side]
- Palpation of the inguinal ducts [incarcerated hernia/incarcerated soft tissue hernia; inguinal testis – malposition of the testis due to disturbance of fetal testicular descent]
- 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) [signs of prostatitis (inflammation of the prostate)]
- If necessary, orthopedic examination – to exclude a vertebragenen cause of pain (spine-related cause of pain).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
