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OSCE Testicular/Scrotal Examination
Related Subjects: |OSCE Eye Exam |OSCE Ear Exam |OSCE Abdominal Exam |OSCE Testicular Exam
👋 Introduction
- 🧼 Wash hands before approaching.
- Introduce yourself, confirm patient’s name & DOB.
- Explain: “I’d like to examine your testicles to check for lumps, swelling or tenderness.”
- Gain consent and ensure privacy with appropriate draping.
🧰 Equipment Needed
- Examination gloves 🥼
- Good lighting 💡
- Sheet/gown for modesty
- Optional: Warm cloth (to relax scrotum)
- Optional: Pen torch 🔦 for transillumination
👀 Step 1: Inspection
- Inspect both sides of scrotum for:
- Asymmetry, swelling, scars
- Skin changes (erythema, ulceration, rashes)
- Bulges (inguinoscrotal hernia, hydrocele)
🤲 Step 2: Palpation of Testes
- Examine each testis separately, gently rolling between fingers.
- Assess size, shape, consistency, tenderness.
- Red flag: A painless, hard intratesticular lump = testicular tumour until proven otherwise 🚩.
- Palpate the epididymis (posterolateral) for tenderness/swelling.
- If swelling present, perform transillumination test:
- Bright glow → hydrocele (fluid-filled).
- No glow → solid mass (e.g. tumour, hernia).
🧵 Step 3: Spermatic Cord & Inguinal Canal
- Palpate cord for thickening, nodules, tenderness.
- Assess for varicocele – feels like a “bag of worms”, more obvious on Valsalva.
- Check inguinal canal for hernia (ask patient to cough/strain).
⚠️ Step 4: Special Considerations
- Infection: Tender, swollen testis or epididymis → epididymo-orchitis (often with fever, dysuria).
- Torsion: Sudden pain + high-riding tender testis in young male = surgical emergency 🚨.
- Mass localisation: Intratesticular (likely malignant) vs extratesticular (hydrocele, epididymal cyst).
✅ Closure
- Thank patient, allow redressing, maintain dignity.
- Summarise: “I felt a soft, transilluminating swelling consistent with a hydrocele” (example).
- Wash hands 🧼 and document accurately.
⭐ Key OSCE Points
- Systematic: Inspection → Palpation → Spermatic Cord → Specials.
- Always compare both testes for symmetry.
- Explain each step → helps patient relax.
- Be ready to state differentials + next steps (USS scrotum, tumour markers).
🚫 Common Pitfalls
- Not gaining consent or failing to maintain dignity.
- Missing subtle varicocele (check with Valsalva).
- Not differentiating intratesticular vs extratesticular lump.
- Forgetting torsion as a red-flag emergency diagnosis.
📚 References
- Clinical Examination – Talley & O’Connor
- Geeky Medics: Testicular Exam
- OSCEstop – Practice stations