Testicular self examination

Performing testicular self-examination (TSE) regularly helps you become familiar with the usual feel of your testicles, so you can recognize any changes if they occur.

All men should check their testicles regularly#

Testicular cancer is most commonly diagnosed in men between the ages of 20 and 50. Although it is relatively uncommon, it has a high cure rate and is more easily treated in its earlier stages.

If you notice any changes in your testicles, see a doctor as soon as possible. It is also worth performing TSE even if you have had testicular cancer or are currently being treated for it, because cancer may develop in the other testicle.

Men who had undescended testicles at birth, or who are infertile, are at greater risk of testicular cancer. If you belong to either of these groups, be especially vigilant and examine your testicles regularly for unusual lumps or swellings.

TSE takes only a minute. Aim to do it about once every four weeks. Choosing a day that is easy to remember, such as the first day of each calendar month, can help you keep to a routine.

If you have been treated for testicular cancer, continue to examine your remaining testicle, as there is a small ongoing chance of cancer developing in it. See your doctor for further information or instruction on TSE, and for prompt diagnosis of any testicular lumps or swellings.

Testicle anatomy#

Key parts of the testicular anatomy include:

• The testicle (or testis) – a small, oval-shaped sex gland that produces sex hormones and sperm.
• The epididymis – a series of small tubes attached to the back of the testicle that collect and store sperm.
• The scrotum – the sac of skin that holds the testicles. The testicles sit outside the body in the scrotum, which helps keep them at the right temperature.

Becoming familiar with the look, feel and shape of your testicles will help you notice any abnormalities. Healthy testicles usually have these characteristics:

• Each testicle feels like a smooth, firm egg.
• Adult testicles range in size from about 15 mL (similar to a bird egg) to 35 mL (similar to a small chicken egg).

One testicle may be slightly larger than the other, and commonly one hangs lower than the other. There should be no pain or discomfort when the testicles and scrotum are handled gently.

How to perform testicular self-examination#

The general procedure is:

• Make sure your scrotum is warm, as the muscles are then relaxed. Many men find it easiest to perform TSE after a shower or bath.
• It may help to stand in front of a mirror, so you can see as well as feel what you are doing.
• Check one testicle first, then the other. Gently roll one testicle between the fingers and thumbs of both hands.
• Feel along the underside of the scrotum to find the epididymis, which sits at the back of the testicle. It should feel like a little bunch of tightly curled tubes.
• Repeat on the other testicle.

TSE should not be painful or uncomfortable. If one or both testicles have become tender or painful, see your doctor.

Symptoms of testicular cancer#

Symptoms can include:

• A testicular lump, usually painless (about one in 10 are painful).
• A sensation of heaviness in the scrotum.
• A persistent ache in the affected testicle.
• A change in the size, shape, consistency or feel of a testicle.

Take notice of anything unusual. Testicular cancer is relatively uncommon, so try not to panic if you find a lump or something that seems unusual, but do have it checked.

See your doctor for a prompt diagnosis#

Several non-cancerous conditions can also affect the testicles, including:

• Epididymo-orchitis – infection of the epididymis and/or testicle that causes inflammation and pain. Treatment is usually antibiotics.
• Testicular torsion – the cord that attaches the testicle to the body twists and cuts off the blood supply. This is a medical emergency.
• Cyst – an abnormal but harmless collection of fluid.
• Varicocele – varicose veins of the scrotum. About 10 to 15 per cent of men have these.
• Hematocele – a blood clot caused by trauma or injury to the testicles or scrotum.
• Undescended testicles – testicles that remain lodged in the lower abdomen rather than moving down into the scrotum. Premature and low-birth-weight newborn boys are most prone to this. It is linked to a higher chance of testicular cancer later in life, as well as to infertility.

Whatever the cause, see your doctor for a prompt diagnosis of any testicular lump, swelling or pain.

Key points#

• Testicular cancer is most commonly diagnosed in men aged 20 to 50, and has a high cure rate when found early.
• Commonly, one testicle hangs lower than the other, and one may be slightly larger.
• Testicular torsion, where the cord attaching the testicle twists and cuts off the blood supply, is a medical emergency.

Where to get help#