Testicular Self-Examination

Men can greatly increase their chances of finding a testicular lump promptly by performing a simple procedure called testicular self-examination (TSE).

HOW TO DO T.S.E.
TSE should be performed once a month after a warm bath or shower. The heat causes the scrotal skin to relax, making it easier to find anything unusual. The procedure itself is simple and only takes a few minutes. Performing the exam more frequently than once a month may cause you to miss a slowly changing lump, but if you do it once a month you will notice changes more easily.

Stand naked in front of a mirror. Look for any swelling on the skin of the scrotum. It is normal for one testicle to be slightly larger and/or hang lower than the other (typically the left testicle hangs lower than the right). If the room is too cool it will be difficult to perform the exam. The exam is best performed after a hot bath or shower as heat relaxes the scrotum making it easier to spot any abnormality.

Examine each testicle gently with both hands by placing your index and middle finger under the testicle with your thumb placed on top. Roll the testicle gently between the thumbs and fingers as shown in Figure 1. The testicle should feel like a hard boiled egg with the shell removed (firm, but not hard and smooth in nature). Feel for a small lump, about the size of a pea on the front or side of the testicle. These lumps are usually painless.

Find the epididymis, a soft, cord-like structure (slightly tender to pressure) that stores and transports sperm, located on the top and back of the testicle as shown in Figure 2. This is a normal lump.

Figure 1 Feel for a small lump, about the size of a pea, on the front or side of the testicle.  These lumps are usually painless.

Figure 2

THE FACTS

• Although cancer of the testes accounts for only about 1% of all cancers in men, it is the number one cancer killer among men in their 20's and 30's.
• Testicular cancer develops more frequently in Caucasian men than in African-American or Asian males.
• Most testicular/scrotal irregularities are not associated with cancer.
• Men with a history of undescended testicles are at higher risk.
• With early detection and treatment, 90% of those affected are cured.
• If in doubt, have it checked out.

Other signs to monitor include any enlargement of the testicle, heavy feeling in a testicle, any significant loss of size of one of the testicles and discomfort in one testicle. Should you develop a breast enlargement, tenderness, or a sudden collection of fluid in your scrotum, you need to seek care. Finding a lump does not necessarily mean you have cancer, but you should contact your doctor right away. The lump may be due to an infection, and a doctor can determine the proper treatment.

Remember that testicular cancer is highly curable, especially when treated promptly. Testicular cancer almost always occurs in only one testicle, and one testicle is all that is needed for sexual and reproductive function.

If you find a lump, call the Dial-A-Nurse at 333-2700 for an appointment.

References
EMedicine Health Web site, search for tse, testicular self-examination
Medline Plus Medical Encyclopedia Web site, search for tse, testicular self-examination

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