Testicular self-examination
Testicular self-examination
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Testicular self-examination

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Testicular self-examination

Testicular self-examination (TSE) is a procedure where a man examines his own testicles and scrotum for possible lumps or swelling. It is usually undertaken at home while standing in front of a mirror and after having a warm bath or shower. Monthly self-examination of the testicles starting at puberty may be an effective way of detecting testicular cancer at an early, potentially treatable stage, which can lead to a 5-year survival rate of 98%. In men aged 15 to 40, testicular cancer is the most common cancer, and the annual rate of increase over the last 10 years in cases of testicular cancer is approximately 1% each year. Testicular cancer typically presents with a painless testicular swelling or a lump or any change in shape or texture of the testicles.

TSE is also indicated if there are certain risk factors present, such as a family history of testicular cancer. Additionally, outside of the possible early detection of testicular cancer, other "off label" uses of TSEs include detection of indirect inguinal hernias, varicocele, and infections that may affect the testicles, such as mumps. The efficacy of TSEs in detection of these pathologies relies on proper technique, but if done correctly, TSEs can be very beneficial to the health of the individual and have many public health benefits as well.[citation needed]

Monthly self-examination of the testicles, starting at puberty, may be an effective way of detecting testicular cancer at an early, and potentially treatable stage. Recommendations vary with some physicians recommending the use of monthly TSE for men ages 15 to 55.

Practitioners may recommend testicular self-exam (TSE) when the following risk factors are present:

There is no general medical consensus for recommendations on TSE. The effectiveness of performing TSE in reducing morbidity and mortality from testicular cancer is not known. Not all organizations endorse the procedure as a screening test, arguing that it may lead to unnecessary treatments and unnecessary anxiety. The benefit of TSE is uncertain due to there being no randomized control trial studying the use of TSE. Many organizations have established guidelines regarding the utilization of testicular self examination as well as the use of testicular examination by a medical provider as a diagnostic tool. These guidelines can be found in the table below.

For men who choose to perform TSE, it is recommended to perform TSE once monthly, at approximately the same time every month. Performing TSE during or after a warm bath or shower may help to relax the skin of the scrotum and make the structures within the scrotum easier to feel.

Existing guidelines indicate that TSE is best performed in the standing position. Individuals performing TSE may choose to stand in front of a mirror in order to visualize the scrotum and testicles from various angles. First, the scrotum and testicles may be visually examined for any skin changes or visible swelling. Then, with the thumb placed on the upper surface and the index and middle finger placed on the lower surface, each testicle can be rolled between the thumb and fingers to feel for potential findings. It is also recommended to locate and feel the epididymis, a soft, rope- or tube-like structure that runs behind each testicle, in order to avoid confusing this structure for a potentially abnormal finding.

Normal findings during TSE include testicles that feel round, smooth, and homogenous in texture, and that are mobile within the scrotum. It is normal and common for one testicle to be larger and hang lower in the scrotum than the other.

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