Anatomy And Examination Of External Genitalia

The genitalia of males and females do not differentiate until week seven of embryonic life. Undifferentiated genitalia consist of a phallus, which becomes either a glans penis or a clitoris, the labio-scrotal swelling, which becomes the scrotal sac or the labia majora, a urogenital fold and the urogenital membrane. The penis around the urethra in males equates to the labia minora in females.

The external genital examination for females involves examination of the mons pubis, the clitoris, the labia majora, and the labia minora along with the openings of the vagina and the introitus. For males the external structures are the penis, the prepuce if present and the scrotum and its contents. The prepuce in the male forms a covering of the glans penis and is also known as the foreskin; in the female the prepuce covers the clitoris and is also known as the cli-toral hood. The prepuce of an uncircumcised man should be retracted to allow visual examination of the glans penis. Excision of both the male and the female prepuce occurs in certain cultures, and this is discussed below.

External examination requires good lighting. A magnifying glass is also a useful tool for the examination of small lesions. The skin is observed for presence of inflammation, excoriation, ulceration, integrity and pigmentation changes. Pubic hair is inspected for signs of infestation and the presence of any warts or other skin tumours is noted. Skin texture is inspected and any thickening or atrophy noted. The inguinal lymph nodes are palpated and swelling or discomfort noted. The contents of the scrotal sac are examined by palpation. The structures are identified and any pain, discomfort, thickening or abnormalities are noted.

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