(e) Venereal history (also affects the reproductive system).
Dysuria (difficulty or pain in urination).
Reproductive system. Obtain information about the following:
(a) Menstrual history of a female should include information about her
last menstrual period (LMP) and post-menstrual pain (PMP). Ask the number of times
she has been pregnant (gravida), the number of pregnancies carried past 20 weeks
(para), and the number of abortions (AB).
(b) Fertility (asked of both men and women).
(c) Potency and libido. Questions about potency and libido are usually
asked in very extensive histories. DO NOT question a patient about these areas in a
routine physical examination.
PROCEDURES FOR PHYSICAL ASSESSMENT OF THE GENITOURINARY
The physical assessments of the genitourinary system for the male and female
have similarities and differences. Procedures for assessment of the rectal areas are the
same for each gender.
a. Male Genitalia Inspection. Examine as follows:
(1) Examine the foreskin by retraction. Check for phimosis (constriction of
the preputial orifice so that the prepuce cannot be retracted over the glans).
Look for lesions, chancres (primarily sores associated with syphilis).
Examine the glans for ulcers, scars, and inflammation.
(4) Check the location of the urethra. A congenital defect that appears in
the male is hypospadias in which the urethra opens on the undersurface of the penis.
Epispadias is a congenital defect that can occur in males and females. In the male, the
urethra opens on the dorsal side of the penis; in the female, there is a fissure in the
upper wall of the urethra.
Check for discharge from the meatus.
Examine the skin around the base of the penis for inflammation, nits, or
Check the scrotum for swelling and inflammation.