Urethral smear that demonstrates at least 5 leukocytes per oil immersion field on microscopy
Inspect the underwear for secretions
Penis: Examine for skin lesions that may indicate other STDs (eg, condyloma acuminatum, herpes simplex, syphilis); in uncircumcised men, retract the foreskin to assess for lesions and exudate
Rectal: During the digital rectal examination, note any perianal lesions
A mucopurulent or purulent urethral discharge
Prostate: Palpate for tenderness or bogginess suggestive of prostatitis
Testes: Examine for evidence of mass or inflammation; palpate the spermatic cord, looking for swelling, tenderness, or warmth suggestive of orchitis or epididymitis
First-voided urine specimen that demonstrates leukocyte esterase on dipstick test or at least 10 WBCs/hpf on microscopy
Urethra: Examine lumen of the distal urethral meatus for lesions, stricture, or obvious urethral discharge; palpate along urethra for areas of fluctuance, tenderness, or warmth suggestive of abscess or for firmness suggesting foreign body
Lymphatics: Check for inguinal adenopathy
