Testicular self examination

Performing regular testicular self-examination (TSE) can help you to become familiar with the usual feel of your testicles so that you can recognise any changes, if they occur. All men should check their testicles regularly. Around 200 Victorian men are diagnosed with testicular cancer every year, most commonly between the age of 20 and 50. This rare cancer has a high cure rate and is more easily treated in its earlier stages. If you recognise changes in your testicles, see a doctor as soon as possible.It is a good idea to perform TSE even if you have had testicular cancer or are currently being treated for it, because cancer may develop in the other testicle.

Risks of testicular cancer

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 vigilant and regularly examine your testicles for unusual lumps or swellings.

Checking your testicles using testicular self-examination

Testicular self-examination only takes a minute. Aim to perform TSE about once every four weeks or so. Choose a day that’s easy to remember, like the first day of every calendar month. If you have been treated for testicular cancer, still examine your remaining testicle because you have a one in 25 chance of developing cancer in this testicle also. See your doctor for further information or instruction on TSE, and for prompt diagnosis of any testicular lumps or swellings.

Testicle anatomy

The anatomy of the testicle includes:

• testicle (or testis) – small, oval-shaped sex gland that produces sex hormones and sperm
• epididymis – a series of small tubes attached to the back of the testicle that collect and store sperm. The epididymis connects to a larger tube called the vas deferens
• scrotum – the skin sac that houses the testicles. Sperm production needs a temperature around 2°C lower than the body, which is why the testicles are located outside the body in the scrotum.

What to expect when performing testicular self-examination

Become familiar with the look, feel and shape of your testicles; this will help you notice any abnormalities.

The characteristics of healthy testicles include:

• 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.
• Commonly, one testicle 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

Generally, the TSE procedure includes:

• Make sure your scrotum is warm and relaxed. You may like to perform TSE after showering or bathing.
• It may help to do TSE in front of the mirror, so you can see as well as feel what you’re doing.
• Check one testicle first, then the other.
• Gently roll one testicle using the fingers and thumbs of both hands.
• Feel along the underside of the scrotum to find the epididymis that sits at the back of the testicle. It should feel like a little bunch of tightly curled tubes.
• Perform TSE on the other testicle.

TSE shouldn’t be painful or uncomfortable. If one or both testes have become tender or painful, see your doctor.

Symptoms of testicular cancer and testicular self-examination

Symptoms of testicular cancer include a testicular lump that is usually painless (about one in 10 are painful), a sensation of heaviness in the scrotum, and a persistent ache in the affected testicle.

Take notice of anything unusual, such as:

• a lump or swelling in or on the testicle itself
• change in testicular size
• change in testicular shape
• change in the consistency or feel of the testicle.

Testicular conditions other than cancer

It’s important to remember that testicular cancer is relatively uncommon, so don’t panic if you find a lump or anything else that seems unusual. See your doctor for a prompt diagnosis.

Some non-cancerous conditions that may affect the testicles include:

• cyst – an abnormal but harmless collection of fluid
• varicocele – varicose veins. About 10 to 15 per cent of men have varicose veins of the scrotum
• haematocele – a blood clot caused by trauma or injury to the testicles or scrotum
• epididymo-orchitis – infection of the epididymis, testicle or both 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 extremely painful condition needs urgent medical attention
• undescended testicles – either one or both testicles are missing from the scrotum and are lodged instead inside the lower abdomen. Premature and low-weight newborn boys are most prone to undescended testicles. This condition is known to increase the chance of testicular cancer later in life and is also linked to infertility.

Where to get help

• Your GP (doctor)
• Healthy Male
• Cancer Council Victoria - Testicular cancer overview