Hernia Exams

I read this blog post, written by a doctor, about hernia exams for sports physicals.

http://distractible.org/?p=2782

While I agree with his assessment that the importance of hernia exams is overblown in regular sports physicals, I was stricken by the way he said he conducts the exam. The buildup associated with announcing the exam, having the patient lower his pants and underwear, and even ushering the accompanying parent out of the room all seem to do nothing but increase the anxiety associated with the procedure. I'm surprised that this doctor would do it this way, seeing as it would be more time-consuming and encourage objections from the patient.

The doctors I saw growing up all did the exam a little differently (and even changed their individual techniques at different visits). For all, I was already wearing only my underwear, so there was no need to fumble with pants. Sometimes he'd pull my underwear down and others he's just feel inside. I was positioned either laying down or standing. If I was standing, I was either facing the parent who went with me who was seated (particularly embarrassing when the underwear came down) with the doctor standing behind me and reaching around or facing the doctor who was seated. I never had to *turn my head* to cough because I was never face-to-face with the doctor. Most importantly, everything happened so smoothly and quickly that before I knew what was happening, it was already done. While some of these positions and techniques worked better than others, they all seem better than what was described in the above posting.

What was your experience with hernia exams? Was it similar to what was described in the blog, what I described, or something different entirely? Were you comfortable with it that way? If not, what would you prefer?

One of my parents was present in the exam room until I was 13 or 14.... and was not sent out at the time of the hernia exam. I was already in my briefs and at the end of the exam was told to stand up. Sometimes the doctor tugged my briefs down or told me to lower them. He would examine my penis and testicles and then have me turn my head and cough. The accompanying parent (usually my mom) remained in the room. At least the chair that she sat on was in the corner... so she pretty much just saw my backside... not my genitals.... But still emabrassing to a boy!

Growing up as a teen i was always naked during physicals,penis and testicals where examined while i was laying down on the exam table ussauly causing me to get an erection which was exteremely humiliating. hernia exams where down with me standing either with me standing the dr would either stand in front of me with one hand on my shoulder and the other on my balls or he would sit on the rolling stool and examine me both very embarrising

Have always had hernia exams standing up with pants pulled down a little. Never found them that embarrassing to be honest.

I do have a hernia check up every 6 months when a I get my pilot´´s physical renewed . Just lower my pants and underware when the doctor has me laying down for general exam.

School and employment exams were in underpants and the hernia exam was done either stood up ie 'drop em' or whilst on exam couch and then requested to 'slip my underpants down', head to the right and cough.

In all of these exams a testicle or penis exam was never carried out, although obviously all my goods were fully on show. This was in the UK with both male and female doctors.

My hernias exams were similar to those mentioned in the blog. simple stand up, drop your pants, and cough.

I did not realize until about 3 years ago that every hernia exam I had ever had was done in an inadequate way. It was only once I had been trained to conduct genital exams by a teaching physician that I realized that most doctors either hold the testicles and tell you to cough, or they poke their finger into your scrotum and tell you to cough. I have never had a doctor push his finger the full 2-3 inches up into my inguinal canal required to reach the inguinal ring where one would feel a developing hernia. By the time an inguinal hernia is felt in the scrotum, it can be seen visually as well.

Since I now teach med students how to perform the male genital exam, I teach them the correct method. No med student gets past me until they can demonstrate the correct method. If I ever encounter one of these students once they become doctors, they damn well better perform a thorough genital exam on me or I will provide them with instant remediation of the procedure.

I have a question: Why are such exams never performed regularly in Europe? When kids go for a sports physicals, doctors never check for hernias.

My family doc didn't do the hernia exam in front of my mom. He would take me into his private office and do the exam there. The first exam was very akward and embarrassing.A couple of years later I was having a physical and the nurse in the room. The doctor said it was time for the hernia exam. The nurse giggled, said "excuse me", and left the room.

The blog post is fantastic. This guy seems like the perfect nerdy doctor who creates a big production out of an embarrassing part of the physical exam. All the explantation he provides just makes the procedure worse and more tedious. It would be great to think back about if one was his patient. My first hernia exams were done in a matter of fact way which minimized the embarrassment and was just a slight departure from the prior exams I had with this doctor. I started seeing him when I was 10. Before that, the doctors I saw did not have my genitalia exposed during exams. They would usually reach into my pants for a quick feel or even omit the genitalia all together. This doctor had me strip to my underwear from the start of the exam. This was quite a significant change over remaining dressed and having the doctor listen with his stethoscope and palpate my body around or through my clothes. This was a feeling of vulnerability being in only my white briefs with a doctor examining me who was completely dressed. And this doctor finished up the exam with a complete examination of my genitalia which were exposed in front of him. The first couple of years I saw him, the exam concluded with me lying supine on the exam table. He did auscultation and palpation of my abdomen and then, without any verbal warning at all, he pulled down my briefs in the front and examined my penis and testes. This was very brief but he did visually inspect everything and moved my penis up onto my abdomen so it was out of his way and he could feel the testes. When the hernia exam was added a couple of years later--I believe at age 12--the routine became a little different. It was still the concluding event in the exam and followed the abdominal exam with me supine on the table. But then, he instructed me to stand at the side of the table and slip my shorts down. None of the nonsense that was described in the blog post occurred because I had had my underwear down in front of him before. And I knew how far down he expected them to go since he had done it for me twice before.

I have had several different experiences with hernia exams beginning in childhood. As with most of the guys here, as a kid, I was already stripped down to my briefs for the entire exam and then had to drop those to my ankles when the doctor examined my testicles and checked me for a hernia. Several times I can remember the doctor pressing so hard under my testicles during the hernia check that I was forced up onto my toes to lessen the uncomfortable pressure. This has happened a few times after I became an adult too. Two doctors that I remember well would insert their finger into the skin of my scrotum to check for a hernia through the inguinal canal. I remember that being very uncomfortable, almost painful. My balls would be sore for several hours after those hernia checks. For group sports physicals at school, the exams were done quickly for a whole line of guys lined up in their underwear or a jockstrap and, except for once or twice, there wasn't the uncomfortable pressure that I usually experienced only at my regular doctor's exam.

Thanks for sharing...really enjoyed the blog post. My childhood hernia checks were mostly as described by other posters. I was always already in my underwear, and the doc would have me stand, lower my underwear (I always spread my legs a bit to stop my underwear at mid-thigh...because, y'know...less naked somehow...silly boy), and then performed the check.

I can't remember if my pediatricians were using proper finger placement, but my current physician does it correctly.

My last complete physical the doctor had me lower my underwear for hernia exam and he said they can just drop to the floor. after that he said just step out of them and put my elbows on table and he performed a prostate exam.

My first hernia exam after puberty started was done at age 13. I was lying down on the examing bed and weearing nothing except for my white briefs.

The doctor's exam was progressing from head-to-toe. She had been palpating my abdomen, and kept working lower and lower. As she got to my lower abdomen, she began to pull the waist band of my underwear down. I remember the surprise that I had that she would actually start to pull my underwear down. That, plus the tickling feeling of her palpating my lower abdomen, caused me to begin to become erect.

Shortly after this, she pulled my underwear down to my knees. This caused me to immeditaely become fully erect, with my penis lifted up and off of my abomen. She examined my testicles and checked for a hernia while I was lying on my back.

I would guess that the entire testicle and hernia exam didn't take more than 20 or 30 seconds. Nevertheless, that was the first time a female ever saw me naked, and it was a very arousing experience for me.

In reply to locke, the reason they are not done is that they are very low-yeild studies.

A lot of kids (maybe 10%) have sliding hernias. That means you only feel the hernia when they cough, and it goes away aferwards. These hernias don't cause any problem; it is just that they are a risk of being a problem later in the kid's life.

A hernia emergency (an incarcerated hernia) is something that the patient would tell his doctor about -- they hurt and, as the blogger mentioned, almost any guy, no matter how shy he is, will tell his doctor if something looks very wrong down there.

I can remember several hernia exams in my life since my early teenage-time. The first were done by my paediatrician. My mom took me often to him when I was teenaged because I had often abdominal problems (therefore, I had also few longer stays at hospital!).

Unfortunately, in that age I was a often sick boy, was underweight and in a pale and sick condition, so that the physical exams there were thoroughly and included always a genital exam, too, because I also had a surgery of my right retained testicle (when I was 6 yrs) and a mild form of phimosis in my youth age, too.

The primarily reason for the hernia check was in my opinion, that I had a small kind of navel hernia, too, and my navel was gnarly protruding, so that I had an outie navel since my early childhood, what the doctor was mostly not content about.

So at the beginning of the examI had to undress everything to my pants and I had to stand upright in front of him, while he was sitting on his chair. He took me on my arms first and watched on me then with strong eyes from head to feet at the front and back, while he was complaint about several things then. He focussed his attention mainly on my abdomen and ordered me to rise up my arms completely, then to give several coughs and to blow my abdomen up and down several times, while he pokes with one finger on my outie navel, that was mostly uncomfortable. Then I had to stand with my legs a bit apart, while he felt my testicles and ordered me to cough 2-3 times again.

When I layed on the exam table, the doctor did the whole and complete physical exam by auscultating my heart, lungs and abdomen, the main and longest part was normally the exam and palpation of my abdomen and my navel (hernia), too, which was often uncomfortable and painful, too (,ost of all I hated that squeezing and pulling at my navel!).

He continued then by palpating my lower abdomen and groin area and ended then by a complete genital exam, that inculdes visual inspection, retraction of my foreskin (phimosis) and palpation of my penis and testicles then. In some rare cases, he pressed with his finger into my scrotum, that I really ouched! Of course, it was always embarrassing for me, too, because my mom sat always inside the room and observed the whole exams.

I didn´t have a real hernia exam at our yearly exam at the school doctor. He admittedly did a thorough and long exam (palpation) of my whole abdomen and even my outie navel, noticed and found fault with umbilical hernia, too, but he did only a visual inspection and palpation of my penis, controlled the retraction of my foreskin (criticized my phimosis!) and only "felt" if my testicles were inside my scrotum, but he didn´t make a deeper palpation of inguinal hernia like other doctors did.

I got other hernia checks by some other doctors, too, including my stays at hospital in my youth age, by the female doctor at my medical exam for military service in Germany and by the company doctor at my education, which went similar to these at my paediatrician earlier.

My experience are always the same, it is done with me standing up in underwear, then dropped it down to expose the groin and genitals. I am always asked to turn my head and cough while she is examing. It is quick and smooth as you described, nothing special. I guess that is what is taught for most doctors when they are in medical schools.

My experience with them was that, they certainly weren't fun, but just another part of the exam. Whichever parent took me to the exam could see the hernia check done. Most often my father took me so there was no issue with that.

I always got a little nervous whenever the doctor would pull down my boxer briefs to examine me. Always being semi hard and embarrased.

I was always standing and it was always the last part of the exam. My mom was present in the room until my early teens and always seemed to be in the corner chair which would always give her a potential view of my front. She always was nose deep in a magazine while it was going on, but it would be hard for her not to have gotten an eye full turning the page.

While growing up the pediatrician that my parents took me to checked for hernias while laying on the exam table. My mom and sister were always at these exam until I was 14. He would pull my underware back and check my penis and testicles. The hernia exam he would push his finger up into the canal on each side of the testical. It did not hurt not was very uncomfortable and took longer than just turn and cough exam.

I changed doctors when I was 15 year old. Every doctor since then has given the hernia exam at the end of he physical. The doctor would check for a hernia while I was standing in front of him with my legs apart a little and my pants pulled to my knees or around my ankles. The doctor usually standing but sometimes seated on a stool would have me turn and cough twice of each side.

The doctor sat on a stool on wheels,

he wheeled it close to me after he had had me lie on the bed. he had already slipped his hands into my groin while i was lying down so i thought i was 'safe' from anything as bad when he told me to come closer . I recall he had me stand up straight and feel my neck . he told me he was feeling my glands. then arms up and i laughed as he felt my armpits.

then he asked (as if i had a choice at that age) something like, "is it ok for me to pull these underpants down now?" he had his hand on my hip. i think i must have nodded.and he always said a sleezy, 'good boy' as he slid them to my knees and he had a first look. In my earliest hernia checks he used his thumb and forefinger to hold each of my balls in turn told me 'big cough now' a few times first whilst he held it still and then as he palpated my scotum. I always went so so red and the more he reassured me, ' good boy, thats good...' the more likely i was to get semi hard.

How old were you aqwerty? and did you actually get hard while you were being examined?

I was about 10 i think

My first one was during a sports physical when I was 14. The nurse escorted me and my mom to the exam room and took my vitals. Then she told me to strip to my underwear and have a seat on the table. When the doctor came in he waited until last for the genital exam. When he asked me to stand up and drop my underwear my mom turned and faced the other way. He just briefly looked at and felt my penis and testicles. Then he did the hernia part, asking me to turn my head and cough. When he told me to bend over the table for a rectal exam I was quite surprised-I wasn't expecting that. He spread my butt cheeks and did a visual observation, then told me to bear down as he inserted a finger in my ass. It only took a couple of seconds but I was embarrassed by the procedure, mostly because I started to get an erection while bending over. Glad mom was looking the other way.

When I was young (six or seven) my doctor would palpate my abdomen and then just lift the waistband of my underwear and press palpate my groin, then quickly make sure my foreskin could be retracted.(Back then, you stripped to the shorts first thing) When I was about 10, my pediatrician was out of town and a husband & wife who were both pediatricians were covering for him. I don't remember why I went in, but that day, the female was covering. She did the exam just like my regular doc did until we got to the genital check. She had me stand up and pulled my shorts to my knees (She was sitting on a rolling stool and was between me and my mother, so I doubt Mom saw more than the surprised look on my face.) Since she had never examined me before, she cupped and gently squeezed my scrotum to make sure both testicles had descended, then retracted my foreskin a couple of times. ( I was still pre-pubescent, but just barely.) I don't remember if she checked for hernias, but it was the first time anyone had done any form of "full" genital exam, and I thought about it often over the next few days. After that, when I went to the doctor's office, Mom waited outside and full genital and hernia check became standard fare, as well as noting body and pubic hair growth, and checking the size of my testicles against a plastic orchidometer.

I sometimes wonder if that exam by Doctor M pushed me over the edge into puberty.

I've found that it gets to the point that the doctor assumes the patient knows what's coming. It's the end of the physical. The patient, who had been lying back on the table, is helped to sit up. The doctor reaches for the glove, the patient is asked to stand. If the patient is stripped to underwear, there may be nothing said. The doctor turns toward him or rolls his stool over, perhaps points or waves. The patient, on auto drive, slides his underwear down or off. Instructions are needed if the patient is still wearing pants and underwear, hence the production number.

Growing up the hernia check was just like everyone else. Stand in front of the doctor and drop your shorts. Turn your head and cough. But then i had an exam once as an adult which caught me off guard. I was lying on my back and the doctor was feeling my abdomen. I had a gown on that was no pushed up and underwear. I really wasn't paying that close of attention as i think i was looking off to the side. Then, without any warning his hand was down my pants and he was telling me to cough. It was very quick, just caught me a bit by surprise.

I think the need for the exam is limited, but maybe the idea is for doctors to have a way to make sure teens are developing properly. My doctor always did a complete genital check for sports physicals, and maybe it conditioned me not to really care about it.