"Turn your head to the right and cough"

Just as women dread the pap smear, men aren't too happy to come in for a genital or rectal exam - something about it being awkward and embarrassing to talk about your "private parts" and even worse to have them inspected. Indeed, some men would rather live with a softball sized hernia or a hemorrhoid bigger than an heirloom tomato than have to strip down and be examined by a medical professional. So what are we checking for in the genital and rectal areas of a man? First off, we're looking for any visible skin lesions such as herpes, warts, or the increasingly rare syphilitic chancre. Most of us then proceed to palpate the the contents of the scrotum for any abnormalities such as tumors of the testicle. Then comes the request to "turn your head to the right and cough." Why turn your head? Mostly so you don't jettison some fatal Ebola from your mouth into our eyes. As you cough, you increase the pressure in your abdominal cavity and press your intestines against the inner side of the abdominal wall. We simultaneously place a finger up your inguinal canal to make sure that your guts are not protruding down that canal towards your scrotum. If something bulges out or "kisses" our finger ever so gently, you have a hernia. Next comes the request to "turn around, place your elbows on the table, and bend slightly at the knees." At this point pray for three things: your life, small fingers, and lubricant. Gloves are a given - or should be. The "finger wave" is our way of checking your rectum and prostate gland for any abnormalities such as cancer. In conclusion, the genitourinary exam is an important part of comprehensive health care and is not as bad as many men fear. In addition, in a recent survey conducted in my mind, nine out of nine men preferred the exam to being poked in the eye with a stick.