About Physical Exam I Just Had

by George
(Front Royal Va.)

I am a 69 year old man. I just had my yearly exam.
I am not circumcised and wondered at what age the foreskin is checked. I can't remember it being done but once since starting high school and a NP did that one.
I have post polio.


George

Comments for About Physical Exam I Just Had

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Complete Physical Exam
by: Elle Bieling, RN, HHP

Hello George,

I am glad that you felt comfortable asking me this question. I am guessing that you did not feel comfortable asking your examiner.

To answer your question, a complete physical examination should always include a complete genital examination. Your health care provider should inspect your penis, your scrotum and do a rectal check for an enlarged prostate. Except for the rectal check, this process should occur at all ages.

Often, though, the health care provider is embarrassed and skips this. I think this happens a lot, most often if the examiner is of the opposite sex. My husband even had to ask once, for the prostate check, because he knew from me that it was a vital part of the complete physical exam. He asked, even though he hates it!

I also suspect that you are asking me this, because you may have a problem with your foreskin. It is not uncommon in older men who are uncircumcised to develop problems later.

Since you have had polio, you may be disabled and caring for yourself may be more difficult. Retracting the foreskin and cleaning the end of your penis is very important for good hygiene and to prevent urinary tract infections.

If you are having difficulty caring for yourself, perhaps a loved one is available to help? If not, then circumcision may be your uncomfortable option.

I even had several patients, who we could not retract the foreskin, but barely enough to perform their daily hygiene. My one patient suffered from repeat urinary tract infections because of this medical condition known as "phimosis." It is painful for the person involved.

Another condition known as "paraphimosis" is when the foreskin is retracted and trapped and then gets swollen. This could cause strangulation of the penis and is considered a medical emergency.

Since it sounds like you get regular exams, if you have not experienced any of these problems, it may be OK to wait until next year to discuss this with your health care provider. If you do have problems, call them back and let them know right away.

The American Cancer Society recommends a prostate-specific antigen (PSA) blood test and a rectal examination annually, beginning at age 50, so I hope you had these done. Methods for preventing prostate cancer is controversial, since false positives are frequent, so make sure you discuss this issue with your doctor.

You can learn to do your own testicular self-exam at http://kidshealth.org/teen/sexual_health/guys/tse.html. I encourage all males of all ages to do this on a monthly basis!

Good luck to you in your journey toward optimal health.
thanks Ms. Bieling
by: Anonymous

thanks so much for your answer, I wish you were
here in this area as your answers are excellent.
Foreskin Check
by: Wayne

Hi George,

The doctor retracts and checks my foreskin at every physical exam. This is just a part of being thorough and your doctor should be doing it.

Regards,
Wayne
Foreskin Retraction and Amputation
by: Frank McGinness

It’s unfortunate these posts are not dated because examinations and recommendations change over time. Priority is to preserve the body. Tight foreskins are 90% retractable by a month of gentle stretching using fingers or if can’t insert a finger then small spreading tools are available. Low dose cortisone can be an added aid. Some men do fine by gently shooting water into their closed foreskin. Urine too can be used like in war. Many men are comfortable with phimosis and think it normal and live out life fine. Foreskin has 16+ functions that is known, like primary penile immune system and primary penile senseless, and maintains a constant pH so best to not use soap inside. It’s mucosa like the eye lids and vagina. It interconnects all the functions of the penis, so removing 50% of the one’s covering attenuates everything. Digital rectum exam and PSA are no longer performed unless there is absolute need because it added little yet caused much grief. Feb. 5, 2018 Ref. Doctors Opposing Circumcision and RACP
Thank you Frank McGinness
by: Elle Bieling

2/5/2018 Thank you for taking the time to add your timely advice. I do not recall when these comments were originally made. I will try to figure out how to add that! Keeping tract of a large website is tricky to manage and things fall through the cracks.

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