Introduction

In this chapter the external genital examination will be considered. External genital examination is an important part of the procedure within genitourinary medicine clinics. Its purpose is to examine and note the external genital anatomy, observe the skin for any anomalies and palpate the inguinal lymph nodes for evidence of swelling or tenderness. It should also be appreciated that this examination is intimate, and care should be taken to ensure that all procedures and their rationales are explained and consent is gained before the examination. It is good practice for medical staff to offer a chaperone for the intimate examination (GMC, 2001).There is currently no guidance for nursing staff regarding chaperones for intimate examination, but it is important to ensure the smooth running of the examination that both the patient and the nurse are comfortable and consent to the procedure. The examination should ideally take place in a well-lit location that is both private and free from interruption and as comfortable as possible for the patient. The examiner's comfort needs also to be considered, particularly in a busy clinic situation, where many patients will be examined by the same practitioner. The examination couch should be capable of mechanical manoeuvring to limit the amount of bending and stretching needed on the part of the examiner. The light source, equally, should be both adequate and movable. Female patients are most readily examined in the lithotomy position.

Examination of two major systems is involved in the external genital examination. These are the skin and the lymph systems. Additionally, genital anatomy is observed. In the following sections these three areas are considered, followed by a description of the more common anomalies seen in UK genito-urinary medicine (GUM) clinics.

Advanced Clinical Skills for GU Nurses. Edited by Matthew Grundy-Bowers and Jonathan Davies © 2007 John Wiley & Sons Ltd

THE SKIN AND THE LYMPHATIC SYSTEM 53

0 0

Post a comment