In standing position inspect the scrotum for size, symmetry and position.
Lift the scrotum and evaluate the underside and posterior surface.
Testis
With gloved fingers feel the testis and note the size, shape, consistency and sensation. Note their relative position to each other.
Epidydimis
Feel for epidydimis immediately behind testis and note the size, consistency and tenderness.
Spermatic cord
Palpate with fingers the spermatic cord along the course from epididymis to superficial inguinal ring.
Identify both vas within scrotum.
Seek varicocele--valasalva if none obvious.
Normal:
Loose wrinkled pouch with two compartments
Left half of scrotum and left testis are lower than the right.
The skin is corrugated.
Testicles are ovoid 3-5 cms in size with a smooth surface. Size amy vary between individuals. Both Testicles are of same size in a given individual. Compression results in a deep unpleasant visceral pain.
The right testicle lies in a higher position than the left.
The epidydimis: Typically found on the posterior surface of the testis like a crescent. It is soft and uniform in character. Tender when sqeezed.