What is a testicular self-examination and how is it performed?

A testicular self-examination is a simple procedure that men can perform regularly to check for any lumps or abnormal changes in the testicles [5]. This exam is an important step in self-care, as it helps you become familiar with what is normal for you, making it easier to notice any changes that could be signs of conditions such as testicular cancer or other issues [5]. Testicular cancer is rare and highly treatable, typically affecting men between the ages of 15 and 40 [1].

Why is a testicular self-examination important?

The testicles, two oval-shaped organs located inside the scrotum behind the penis, are responsible for producing male hormones and sperm [1]. Because they are not protected by bone or muscle, they are susceptible to injury [1]. The testicles can become inflamed or infected, and lumps or tumors may develop [1]. Regular self-examination, which is recommended to start from puberty (usually around age 12), helps in identifying any changes early on [5]. For example, testicular cancer does not usually cause pain, but it often appears as a lump or swelling [3].

How to perform a testicular self-examination

It is recommended to examine your testicles regularly, about once a month [5]. The best time to perform the exam is during or after a warm shower, as the heat helps relax the scrotum, making it easier to feel the testicles [5]. Follow these steps:

• Hold your scrotum (the skin covering the testicles) in the palm of your hand [5].
• Use your other hand to gently roll one testicle between your thumb and fingers [5].
• Feel behind both testicles; the small, soft tubes at the back of the testicles (the epididymis) can sometimes become firm, swollen, or tender [5].
• Check for lumps or swellings on the testicles; the testicles should feel smooth and firm, but not hard [5].
• Check for any changes in the size, weight, or shape of the testicle. It is common for one testicle to be slightly larger or hang lower than the other, but you should be aware of any new changes [5].
• Be aware of anything else that feels abnormal for you [5].

When to seek medical attention

You should see a doctor if you notice any of the following changes during your self-examination [5]:

• A lump or swelling in one or both testicles [5].
• An increase in the size of one or both testicles [5].
• A feeling of heaviness, hardness, or firmness in the scrotum [5].
• Pain or aching in the scrotum, or in one or both testicles [5].
• Any change in one or both testicles that does not feel normal for you [5].
• A lump, pain, or change in the tubes located behind each testicle (the epididymis) [5].

These symptoms, including testicular lumps and swelling, are very common and can be caused by many different conditions. Their presence does not necessarily mean you have testicular cancer, but it is important to have them checked by a general practitioner [5]. If symptoms are caused by testicular cancer, detecting them early may make treatment easier [5].

In some cases, sudden and severe testicular pain may be a sign of an emergency such as testicular torsion, where the testicle twists on itself and cuts off the blood supply [3]. This condition requires immediate hospital treatment to prevent damage to or loss of the testicle [4]. If you experience sudden and severe testicular pain, or testicular pain accompanied by nausea, vomiting, or abdominal pain, or testicular pain that lasts for more than an hour, you should go to the emergency department immediately [3].

For broader information on common testicular disorders, you can visit Common Testicular Disorders: Causes, Symptoms, and When to Seek Medical Attention (Arabic).

Medical references

• Testicular Disorders
• How to check your testicles - NHS
• Testicle pain - NHS
• Testicular torsion surgery - Overview | Guy's and St Thomas' NHS Foundation Trust