Test Overview

Testicular exam and testicular self-exam are
two ways to find lumps or other problems in the
testicles.

The two testicles, or testes,
are the male sex organs. They are located in the scrotum, a pouch below the penis. The testicles make 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 a
coiled tube called the epididymis. It stores sperm.

The testicles develop
in the belly of an unborn male baby. In most cases they move down into the scrotum before or soon after birth. But sometimes they do not descend as expected. Having an undescended testicle can increase the risk for
testicular cancer.

Testicular exam

This is a complete physical exam of the groin and the genitals, which are the penis, scrotum, and testicles. Your doctor will feel the organs and check them for lumps, swelling, shrinking, and other signs of a problem.

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 problems they were born with, such as an
undescended testicle. An undescended testicle is more
common in premature babies than in full-term babies.

Testicular cancer is
rare, but it is the most common cancer in men younger than age 35. It often appears as a
painless lump or swollen testicle. In the early stages of the cancer,
the lump may be about the size of a pea.
In many cases, this cancer is found by the man himself or by his sex partner. The chance of cure is very high when this cancer is found early and treated right away.

Testicular self-exam

A self-exam can help find testicular cancer at an early stage. Many times this cancer is found during self-exam as a
painless lump or a swollen testicle.

Why It Is Done

Testicular exam

This exam can help find the causes of symptoms like pain, inflammation, swelling, or lumps in the
testicles. It can also look for problems such as an absent or undescended testicle.

Testicular self-exam

Self-exam helps a man learn the normal size,
shape, and weight of his testicles and the area around the scrotum. This helps him notice any changes from normal.

How To Prepare

You do not need to do anything special to prepare for an exam done by your doctor. But for comfort, you
may want to empty your bladder ahead of time. You will be asked to undress and put
on a hospital gown.

A self-exam is painless
and takes only a minute. It is best to do it after a bath or shower, when the
muscles of the scrotum are warm and relaxed.

How It Is Done

Testicular exam

The exam may be done
first while you are lying down. Then it may be done again while you are standing. Your doctor will check your belly, your groin, and your penis,
scrotum, and testicles. The doctor will feel the scrotum and both testicles to check
their size, weight, and texture. The doctor will also look for signs of
swelling or lumps. The doctor will note if a testicle is missing or if the testicles are shrinking.

If a lump is found in a testicle, the doctor
will place a strong light behind the testicle. This is to see whether light can
pass through it.

  • Light will not pass through a tumor. Also, a testicle with a tumor generally looks
    heavier than a normal testicle.
  • Light will pass through a mass or swelling caused by a
    hydrocele. A
    hydrocele is a buildup of fluid. It feels like water in a thin plastic bag.

The other testicle will
be felt and checked too, to make sure it does not have any lumps, masses, or
other problems.

Your doctor will also check the
lymph nodes in your groin and your inner thigh for swelling.

Testicular self-exam

To do a self-exam, stand and place your right foot on a chair or other surface about chair height. Then gently feel your scrotum until
you locate the right testicle. Roll the testicle gently but firmly between your
thumb and fingers of both hands. Check the surface carefully for lumps. The
skin over the testicle moves freely, so it is easy to feel the whole surface
of the testicle.

Repeat the process on the other side. Lift your left leg
and check your left testicle. Feel the whole surface of both
testicles.

How It Feels

An exam done by your doctor may cause mild discomfort if your testicles are tender or swollen. And anytime the genital area is touched, there is a chance your
body will react. So you may have an erection. This is normal, and your doctor knows this. You do not need to feel
embarrassed.

A self-exam does not cause pain or discomfort unless a testicle is swollen or
tender. A lump that is cancer usually feels firm. But it probably will not be tender
or painful when pressed.

Risks

There is no chance of a problem from having a testicular
exam or doing a self-exam.

But there is a chance that these exams might appear to find a problem when there isn’t one. This is called a false-positive result. False-positive results may lead to tests or treatments that you don’t need.

Results

Testicular exam and testicular self-exam are
two ways to find lumps or other problems of the
testicles.

Testicular exam and testicular self-exam
Normal:

Each testicle feels firm but not
hard. The surface is 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 a little
lower than the other. One testicle may be a little larger than the other.
This difference is usually normal.

There is no pain or discomfort during
the exam.

Abnormal:

A small, hard lump (often about the size of
a pea) is felt on the surface of the testicle, or the testicle is swollen. If you notice a lump or swelling during a self-exam, contact your doctor right away. This may be an early sign of
testicular cancer. Prompt treatment gives the
best chance for a cure.

One or both testicles are absent. If you
cannot feel two testicles while performing a self-exam, contact your doctor. You may have an
undescended testicle. If you cannot feel both testicles in your baby’s scrotum, talk to his doctor.

A soft bunch of thin tubes (often
called a “bag of worms” or “spaghetti”) is felt above or behind the
testicle. This may mean there is an enlarged, twisted vein in the scrotum, called a
varicocele.

Sudden pain or swelling in the
scrotum is noticed during the exam. This may mean
an infection, such as epididymitis. Or it may mean blood flow to the
testicle is blocked (testicular torsion). Either of these needs to be checked by a doctor right away.

A lump that is
not attached to a testicle is floating in the scrotum. This is not a cause for
concern.

What Affects the Test

Your doctor will talk with you about anything that might keep you from having these exams or that may change the results.

What To Think About

  • An undescended testicle may increase the risk of
    testicular cancer. Parents should check their children or have them checked by
    a doctor to be sure that both testicles have descended before puberty.
  • Experts may not agree about screening for testicular cancer. For example, the U.S. Preventive Services Task Force does not recommend routine testicular exams or self-exams for teens and men who have no symptoms.footnote 1 According to this expert group, the evidence shows that these exams have only a small benefit and may cause harm from false-positive results that lead to having tests or treatments you don’t need.

To learn more about the diagnosis and treatment of testicular cancer, see the topic Testicular Cancer.

References

Citations

  1. U.S. Preventive Services Task Force (2011). Screening for Testicular Cancer: Reaffirmation Recommendation Statement. Available online:

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.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS – Urology, Oncology

Current as ofMarch 14, 2017