Are you supposed to check a boy's foreskin during a physical?

[RNMikeMiller]

On 6/3/2016 at 9:04 PM, CamilliaJGP said:

Read this article below

https://healthunlocked.com/sensitiveissuesmen/posts/136044920/patient-modesty

[djmatte, ADN, MSN, RN, NP]

Again, why are we resurrecting two year old threads? You're new to these forums as of a month ago. But every post you've made has been regarding gender diversity and personal issues with seeing the opposite sex.

[KatieMI, BSN, MSN, RN]

I never do it unless there are relevant complains/other relevant indications. Too many individual variables and too little chance to find something warranting any further action if there is no other stuff going on, therefore it doesn't worth my time and trouble. For the remaining cases like STD check, Paget's, RA, etc, most adult or teenaged males are perfectly able to pull it themselves if asked to do so.

Theoretically, breast exam on females should include nipples palpation and attempt to extract fluid, and PE on males should also include careful palpation of breasts. Honestly, how many of us do that outside of specialty practice?

[djmatte, ADN, MSN, RN, NP]

3 hours ago, KatieMI said:

I never do it unless there are relevant complains/other relevant indications. Too many individual variables and too little chance to find something warranting any further action if there is no other stuff going on, therefore it doesn't worth my time and trouble. For the remaining cases like STD check, Paget's, RA, etc, most adult or teenaged males are perfectly able to pull it themselves if asked to do so.

Theoretically, breast exam on females should include nipples palpation and attempt to extract fluid, and PE on males should also include careful palpation of breasts. Honestly, how many of us do that outside of specialty practice?

Well woman exams 25 and over per ACOG guidelines should have a breast exam offered every 1 to 3 years. Breast exams are pretty standard of practice in my clinic and one of my precept locations were sticklers on them. And that’s primary care. I’ll admit male exams aren’t to the same scale or consideration unless there’s a specific complaint. But I’m unaware of any recommendations for that specifically.

[KatieMI, BSN, MSN, RN]

1 hour ago, djmatte said:

Well woman exams 25 and over per ACOG guidelines should have a breast exam offered every 1 to 3 years. Breast exams are pretty standard of practice in my clinic and one of my precept locations were sticklers on them. And that’s primary care. I’ll admit male exams aren’t to the same scale or consideration unless there’s a specific complaint. But I’m unaware of any recommendations for that specifically.

The evidence of usefulness of manual breast exam is controversial, whatever ACOG wanna say:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974039/

(this is far from the only one)

Better to spend time educating patients about importance of screening studies and doing what can be done to improve access for them, IMHO

[djmatte, ADN, MSN, RN, NP]

1 hour ago, KatieMI said:

The evidence of usefulness of manual breast exam is controversial, whatever ACOG wanna say:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974039/

(this is far from the only one)

Better to spend time educating patients about importance of screening studies and doing what can be done to improve access for them, IMHO

Did you actually read the conclusion?

“A significant number of cancers would have been missed if cbe had not been performed. Compared with cancers detected by mammography alone, those detected by cbehad more aggressive features. Clinical breast examination is a very low-cost test that could improve the detection of breast cancer and could prompt breast ultrasonography in the case of a negative mammogram.“