Testicular Examination and Testicular Self-Examination (TSE)
Testicular examination and testicular
self-examination (TSE) are two methods to detect lumps or
abnormalities of the
Testicular examination and testicular self-examination (TSE)
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.
What Affects the Test
There is nothing that interferes with a testicular examination or testicular self-examination
What To Think About
Undescended testicles may be a risk factor for
testicular cancer. Parents should check their children or have them checked by
a doctor to be sure that both testicles have descended properly
Experts have different recommendations for screening for testicular cancer . For example, the U.S. Preventive Services Task Force (USPSTF) advises against routine testicular exam or testicular self-exams in teens and men who have no symptoms.1 The USPSTF says that the evidence shows that these exams have only a small benefit and may cause harm from false-positive results that lead to having diagnostic tests or procedures you don't need.
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.