WHAT IS INVOLVED IN SOME STEP OF THE PHYSICAL STD EXAMINATION FOR MEN
1. If there is discharge, a small amount will be put on a swab, and tests can then be performed to test for various specific causes of urethral infection, such as gonorrhea and chlamydia. If there is no discharge, then a small swab will be inserted about 2 centimeters into the urethra and quickly removed; the swab is wiped on a slide, which is examined under a microscope for pus cells. The swab can cause pain, but the procedure is done quickly and the pain is usually brief. Another way of examining the urethra is to collect urine from the very first part of the stream and look for pus cells in this sample. New techniques also allow testing for gonorrhea and chlamydia from this first urine sample. (Whether or not a swab or urine sample is taken, it is very important that a man not urinate for four or more hours [and preferably overnight] before this part of the examination, since urination may wash out evidence of infection.) After this, a midstream urine sample may be tested to look for evidence of a bladder infection, a rare occurrence in men.
2. The anal area and buttocks will be examined for any rashes, bumps, or sores. Swabs may be taken from this area (to test for gonorrhea and chlamydia) if a man has been the recipient of anal sex or has STD symptoms in the anal area. If the man has diarrhea, a stool sample may be obtained to test for evidence of intestinal infections. Whatever a man’s sexual orientation, an anal examination is an important part of the screening. For example, genital warts and herpes lesions can occur in this area even if a man has never received anal sex. A procedure called an anoscopy may be performed if there are symptoms in the anal area or if the man has diarrhea. In an anoscopy, a small plastic speculum is inserted into the anal area to look for changes in the lining of the rectum or for skin lesions such as warts. If there are no symptoms in this area, this is not a routine part of the examination. 8. A prostate examination may be performed. (This is not routinely done during an STD screen unless symptoms indicate a need for it.) The health care provider will ask the man to bend over the table and then will insert a gloved, lubricated finger into the anal area. Not only can abnormalities of the wall of the rectum be felt, but the prostate gland can also be felt to determine whether it is swollen, tender, or irregular in shape. This part of the examination may cause brief discomfort. The man may be asked to provide a sample of urine after this part of the examination to test for evidence of prostate infection. This is best done after the earlier urine samples have been collected to evaluate for urethral infection and for bladder infection.
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