Circumcision, meatal opening, hypospadias, phimosis, adherent foreskin, size of testes, cryptorchidism, scrotum, hydrocele, hernia, pubertal changes.
A. In examining a suspected case of cryptorchidism, palpation for the testicles should be done before the child has fully undressed or become chilled or had the cremasteric reflex stimulated. In some cases, examination while the child is in a hot bath may be helpful. The boy should also be examined while sitting in a chair holding his knees with his heels on the seat; the increased intra-abdominal pressure may push the testes into the scrotum.
B. To examine for cryptorchidism, one should start above the inguinal canal and work downward to prevent pushing the testes up into the canal or abdomen.
C. In the obese body, the penis may be so obscured by as to appear abnormally small. If this fat is pushed back, a penis of normal size is usually found.