Test Overview

Testicular examination and testicular self-examination (TSE) are two different methods to detect lumps or abnormalities of the testicles.

The two testicles, or testes, are inside the scrotum. The testicles are the male reproductive organs that produce sperm and the male hormone testosterone. Each testicle is about the size and shape of a small egg. At the back of each testicle is the epididymis, a coiled tube that collects and stores sperm.

The testicles develop within the abdomen of a male baby (fetus) and normally descend into the scrotum before or shortly after birth. A testicle that has not descended can increase the risk for testicular cancer.

Testicular examination

A testicular examination includes a complete physical exam of the groin and genital organs (penis, scrotum, and testicles) by your doctor. Your doctor will feel (palpate) the organs and examine them for the presence of lumps, swelling, shrinking (testicular atrophy), or other visual signs of an abnormality. A testicular examination can detect the causes of pain, inflammation, swelling, congenital abnormalities (such as an absent or undescended testicle), and lumps or masses that may indicate testicular cancer.

A genital exam is an important part of a routine physical exam for every teenage boy and man. Baby boys should also have their genitals checked for congenital abnormalities or an undescended testicle. An undescended testicle is more common in premature male babies than in full-term male babies.

Some doctors recommend regular testicular exams for males ages 15 to 40 to detect testicular cancer in its early stages. Testicular cancer is one of the most common cancers in men younger than age 35. Many testicular cancers are first discovered by men themselves, or by their sex partners, as a lump or enlarged swollen testicle. In the early stages of testicular cancer, the lump, which may be about the size of a pea, usually is not painful. Testicular cancer found early and treated promptly has a very high cure rate.

Testicular self-examination (TSE)

Testicular self-examination (TSE) may detect testicular cancer at an early stage. Many testicular cancers are first discovered by self-examination as a painless lump or an enlarged testicle.

Some doctors recommend that men ages 15 to 40 perform monthly testicular self-examination. But this is controversial. Many doctors do not believe monthly TSE is necessary for men at average risk of developing testicular cancer. Monthly TSE may be recommended for men at high risk of developing testicular cancer. This includes men with a history of an undescended testicle or a family or personal history of testicular cancer.

Many testicular lumps are cancerous and require immediate treatment. Usually the affected testicle is removed by surgery. In some cases, the lymph nodes may also be removed, and chemotherapy or radiation therapy may be given. An artificial testicle may be inserted into the scrotum to provide a normal appearance. Because one normal testicle remains, a man's sexual and reproductive functions usually are not affected.

Why It Is Done

Testicular examination

A testicular examination may detect the causes of pain, inflammation, swelling, congenital abnormalities (such as an absent or undescended testicle), and lumps or masses in the testicles.

Testicular self-examination (TSE)

Testicular self-examination (TSE) is done to familiarize a man with the normal size, shape, and weight of his testicles and the area around the scrotum. This allows him to detect any changes from normal.

How To Prepare

No special preparation is needed before a testicular examination by your doctor. But for comfort, you should empty your bladder ahead of time. You will be asked to undress and put on a hospital gown.

Testicular self-examination (TSE) is painless and takes only a minute. It is best performed after a bath or shower, when the scrotal muscles are warm and relaxed.

How It Is Done

Testicular examination

The examination may be done initially while you are lying down, then repeated while standing. Your doctor will inspect your abdomen, groin, and genital area (penis, scrotum, testicles). The scrotum and both testicles will be felt (palpated) for their size, weight, texture, and consistency and for physical signs of swelling, lumps, or masses. The absence of one testicle usually indicates an undescended testicle. Shrinking (atrophy) of one or both testicles will also be noted.

If a mass is found in a testicle, your doctor will place a strong light behind the testicle to see whether light can pass through it (called transillumination). A testicular tumor is too solid for light to pass through it. Also, a testicle with a tumor generally appears heavier than a normal testicle. A palpable mass or swelling caused by a hydrocele will allow light to pass through it. A hydrocele feels like water in a thin plastic bag. The other testicle also will be felt and examined to make sure it does not contain any lumps, masses, or other abnormalities.

Your doctor will also feel the lymph nodes in your groin and along your inner thigh for signs of enlargement.

Testicular self-examination (TSE)

TSE is best performed after a bath or shower, when the scrotal muscles are warm and relaxed. If you do the exam at another time, remove your underwear so that your genitals are exposed. See a picture of testicular self-examination.

Stand and place your right leg on an elevated surface about chair height. Then gently feel your scrotal sac until you locate the right testicle. Roll the testicle gently but firmly between your thumb and fingers of both hands, carefully exploring the surface for lumps. The skin over the testicle moves freely, making it easy to feel the entire surface of the testicle. Repeat the procedure for the other side, lifting your left leg and examining your left testicle. Feel the entire surface of both testicles.

How It Feels

A testicular examination by your doctor may cause mild discomfort if your testicles are painful, swollen, or inflamed. Whenever the genital area is touched, there is a possibility your body will react, and you may have an erection. This is a normal response that your doctor is aware of and you do not need to feel embarrassed.

Usually there is no pain or discomfort associated with a testicular self-examination (TSE) unless a testicle is swollen or tender. A cancerous lump usually is firm to the touch and usually is not tender or painful when pressed.

Risks

There are no risks linked with a testicular examination or testicular self-examination (TSE).

Results

Testicular examination and testicular self-examination (TSE) are two different methods to detect lumps or abnormalities of the testicles.

If you cannot feel both testicles in your baby's scrotum (descended), talk to his doctor.

What Affects the Test

There is nothing that interferes with a testicular examination or testicular self-examination (TSE).

What To Think About

• Undescended testicles may be a risk factor for testicular cancer. Parents should check their children or have them checked by a doctor to be sure that both testicles have descended properly before puberty.
• Experts differ in their recommendations for testicular cancer screening.

References

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