Do we still need to physical examination in andrology?

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VOLUME 114, ISSUE 3, P483

Author:

Mark Sigman, M.D.

Abstract:

The standard paradigm for the evaluation of patients has been the collection of history, the performance of a physical examination (exam), followed by laboratory testing if needed. The recent rapid move toward telemedicine has brought to the front the question of the value or necessity of the physical exam. With modern tests and technology, is this time-tested practice necessary? If it provides information of use to help direct patient management, it is likely of value. For the male exam, the 2 primary components are the visual exam and palpation of structures/organs. Some of the exam can be obtained through video, for example, to determine whether the patient is normally androgenized, whether 2 testes are present, whether hypospadias is present. However, some of the most valuable exam components still rely on palpation. Assessment of the size of testes remains a vital part of the algorithm to evaluate males with azoospermia. Smaller testes suggest (but do not prove) impaired spermatogenesis. Are they tender or do they have a mass suggesting testicular cancer? Are they abnormally soft or firm? These questions still require the physical exam.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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