Begin by washing your hands
Introduce yourself, explain that you plan to perform an examination of the scrotum and gain verbal consent
The patient should be exposed from the waist down

Inspect
Begin by inspecting the scrotum with the patient standing
Is there an obvious swelling? Is this focal or is there a hernia?

Transilluminate
If there is an obvious swelling use a pen torch to see if the swelling transilluminates

Palpate
Palpate the swelling
Ask the patient to cough
Can you get above the lump?
Is the testicle separate from the lump?
Is there a cough impulse?
Is the swelling hard/soft? craggy/smooth? Tender/non-tender?
Palpate both testes and the epididymis
Groin lymph nodes for enlargement

Abdominal Exam
Ask the patient to lie down to see if the swelling disappears
If there is an obvious hernia above the swelling be sure to examine this also and ask the examiner if they would like you to perform a formal abdominal examination to exclude intra-abdominal malignancy

Close
Thank the patient, tell them to dress
Wash your hands