Testicular examination and testicular self-examination (TSE) are
two methods to detect lumps or abnormalities of the
The two testicles, or testes,
are inside 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
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
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
undescended testicle. An undescended testicle is more
common in premature male babies than in full-term male babies.
Testicular cancer is
rare, but it is the most common cancer 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
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.
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
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.
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.
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
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
Your doctor will also feel the
lymph nodes in your groin and along your inner thigh for signs of
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.
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
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
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.
There are no risks linked with a testicular
examination or testicular self-examination (TSE). But false-positive results may lead to diagnostic tests or procedures that you don't need.
Testicular examination and testicular
self-examination (TSE) are two methods to detect lumps or
abnormalities of the
Each testicle should feel firm but not
hard, and the surface should be very smooth, without any lumps or bumps. The
spongy, tube-shaped structure (epididymis) may be felt on the top and down the
back side of each testicle. One testicle (usually the left) may hang slightly
lower than the other, and one testicle may be slightly larger than the other.
This difference is usually normal.
No pain or discomfort is experienced during
testicular examination or TSE.
A small, hard lump (often about the size of
a pea) is felt on the surface of the testicle, or the testicle is swollen or
enlarged. If you notice a lump or swelling during TSE, contact your doctor immediately. Do not delay or wait for the lump to go away, because
it may be an early sign of
testicular cancer. Immediate treatment provides the
best chance for a cure.
One or both testicles are not felt. If you
cannot feel one or both testicles while performing TSE, contact your doctor. This may mean an
A soft collection of thin tubes (often
referred to as a "bag of worms" or "spaghetti") is felt above or behind the
testicle. This may mean a
Sudden (acute) pain or swelling in the
scrotum that is noticed during the testicular examination or TSE may mean
an infection (epididymitis) or blockage of blood flow to the
testicle (testicular torsion), either of which requires immediate
A free-floating lump in the scrotum that is
not attached to a testicle may be present but is not a cause for
If you cannot feel both testicles in your baby's scrotum
(descended), talk to his doctor.
There is nothing that interferes with a testicular examination or testicular self-examination
To learn more about the diagnosis and treatment of testicular cancer, see the topic Testicular Cancer.
U.S. Preventive Services Task Force (2011). Screening for Testicular Cancer: Reaffirmation Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf10/testicular/testicuprs.htm.
Other Works Consulted
American Cancer Society (2012). Can testicular cancer be found early? Testicular Cancer Detailed Guide: Early Detection, Diagnosis, and Staging. Available online: http://www.cancer.org/Cancer/TesticularCancer/DetailedGuide/testicular-cancer-detection.
Rew L, et al. (2005). Development of the self-efficacy for testicular self-examination scale. Journal of Men's Health and Gender, 2(1): 59–63.
Stephenson AJ, Gilligan TD (2012). Neoplasms of the testis. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 837–870. Philadelphia: Saunders.
December 28, 2012
E. Gregory Thompson, MD - Internal Medicine
& Christopher G. Wood, MD, FACS - Urology, Oncology
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