How to perform a testicular self exam

Julia Knox, MPH, is a full-time Data Scientist with Rotunda Solutions, and a graduate student in Narrative Medicine, within Columbia University’s Department of Medical Humanities and Ethics.

Douglas A. Nelson, MD, is a board-certified oncologist and hematologist who previously served for 13 years as a physician in the US Air Force.

Testicular cancer is cancer of the testes, which are located within the scrotum, underneath the penis. The testicles produce male sex hormones and sperm, and cancer affecting these organs can result in male infertility.

Most cases of testicular cancer can be found early when the cancer is small and hasn’t spread, Early diagnosis is incredibly important so that treatment can be started as soon as possible. The first sign of testicular cancer is usually a lump on the testicle or swelling in the testicle, which can usually be detected through a self-exam. Testicular self-exams are quick and easy to do on your own. If you notice anything abnormal during this exam, you should discuss it with your doctor.

How Common Is Testicular Cancer?

Testicular cancer is uncommon, affecting one in 250 males. The American Cancer Society estimates that 9,470 new cases of new testicular cancer will be diagnosed and 440 deaths will be caused by this type of cancer in 2021.

Testicular cancer can affect males of any age. It is the most prevalent cancer among males aged 18 to 39. The incidence of testicular cancer in those aged 15 to 54 is increasing, and most cases are found in males under 35 years old. The exact reason for this increase is not known. This type of cancer can usually be treated successfully.

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How Often Should You Check Your Testicles?

Most physicians recommend performing a self-check once every month. By checking regularly, males will have an easier time noticing when something has changed.

Some researchers suggest:

  • Reinforcing proper guidelines for testicular self-exams
  • Patient education about the success rate in treating early-detected testicular cancers
  • Making this examination a routine part of adolescent and adult male overall health and wellness self-care

The American Cancer Society does not have specific guidelines about the frequency of testicular self-exams. The United States Preventive Services Task Force (USPSTF) states that there is a lack of evidence that testicular self-exams are beneficial for reducing mortality (death).

The USPSTF recommendation asserts that the potential harms—mainly anxiety—outweigh the benefits of self-screening. There is also a high risk of false-positive results. However, considerable evidence in the literature support self-exams as helpful in detecting testicular cancer.

How to Perform a Testicular Self-Exam

A self-exam should be done during or after a shower because the heat will relax the skin of the scrotum and make it easier to perform a self-exam.

To perform a testicular self-exam, follow the steps below:

  1. Place the index and middle fingers of both hands to support the bottom of the scrotal sack. The testicle is located inside the scrotal sack, and is shaped like a bean. Perform the exam one testicle at a time.
  2. Hold your testicle between your thumbs and fingers with both hands and roll it gently between your fingers. You should not experience any discomfort during this exam.
  3. Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of your testicles.

You may find it helpful to perform the exam in front of a mirror. You could even incorporate visual cues into your environment, such as a reminder on your bathroom mirror, or a smartphone reminder, to ensure this becomes a regular part of your self-care regime.

What to Do If You Find a Lump

If you find a lump, see a doctor immediately. Don’t put it off. There is nothing to feel embarrassed about in seeking medical advice about a potential lump. In fact, you should be proud for taking steps to take care of your health.

You can see your primary care doctor or a urologist. A urologist is a doctor who specializes in treating disorders of the urinary tract and male reproductive system. Depending on your situation, your doctor might order an ultrasound exam to see if there is a tumor in your testicles, and may order more tests if they think the lump is cancer.

When a Lump Isn’t Cancer

Most lumps are not cancerous. In a study that included 845 patients who had a lump or pain in their testicles, only 33 (4%) were ultimately diagnosed with testicular cancer. However, this is not a reason to avoid consulting with your healthcare provider if you suspect a lump. It is best to rule out the possibility of a cancerous lump rather than to assume it is harmless.

In the 845 patient cohort, the most common causes of testicular lumps were epididymal cysts (27%) and hydrocele (11%).

Other causes of testicular lumps:

  • Epididymal cysts may also be referred to as spermatoceles or spermatic cysts. The epididymis transports and stores sperm, and sometimes dead sperm can become trapped there. Epididymal cysts do not cause infertility, but they may cause your testicles to feel heavier, and you may experience swelling or locate a bump that could be mistaken for testicular cancer. Epididymal cysts are quite common, and they are usually benign.
  • Hydroceles are buildups of fluid inside a body cavity. A hydrocele between the parietal and visceral layers of the tunica vaginalis (a serous membrane covering the testes) was the second most common explanation for lumps in the study mentioned above.
  • A varicocele, which occurs when the veins in the testicle dilate, can cause enlargement and lumpiness around the testicle that may be mistaken for a cancerous lump as well.

A Word From Verywell

Testicular cancer is highly treatable if found early, and self-checks can help. Performing a self-exam on a regular basis can potentially help identify the problem early if it is present. Consider adding reminders on your smartphone to help you remember to perform self-exams.

If you notice a lump during your self-exam, schedule a visit with your doctor right away. Remember that a lump may or may not be cancerous and that a lump can be a result of other treatable causes. Even if it is cancerous, testicular cancer is usually treated successfully.

This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhir’s expertise includes minimally-invasive treatments for enlarged prostate (UroLift), kidney stone disease, surgical management of urological cancers, and men’s health (erectile dysfunction, low testosterone, and infertility). His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.

There are 15 references cited in this article, which can be found at the bottom of the page.

This article has been viewed 343,727 times.

Testicular cancer is a rare form of cancer, impacting one in every 5,000 men. It can occur in men at any age; however 50% of cases occur in men between the ages of 20 and 35. [1] X Trustworthy Source American Cancer Society Nonprofit devoted to promoting cancer research, education, and support Go to source Fortunately, testicular cancer also has a very high ratio of diagnosis to recovery, with a 95–99% cure rate. [2] X Research source As with most cancers, early detection is critical to successful treatment and recovery. Understanding risk factors, symptoms, and conducting routine testicular exams is an important part of early detection. You can give yourself a testicular exam once a month in the shower to detect any irregularities early. [3] X Expert Source

In this Article

  • What Is a Testicular Exam?
  • Who Needs a Testicular Exam and How Often?
  • How to Do a Testicular Exam
  • Is It Testicular Cancer?

What Is a Testicular Exam?

A testicular exam is a check of the look and feel of your testicles, to see if there may be any problems. You or your doctor can do it.

The testicles are part of a man’s sex organs. They’re in a pouch called the scrotum, located behind and below the penis. They make sperm and the male hormone testosterone.

Who Needs a Testicular Exam and How Often?

Every man should have a testicular exam. There is no recommendation that a testicular exam should be part of your annual physical exam. But your doctor may suggest that you do a self-exam on a regular basis. Some doctors recommend checking your testicles once a month. Others say it’s fine to have your doctor check once a year.

If you are having problems, or notice a lump or other changes in how your testicles feel or look, tell your doctor.

Exams can be a good way to find lumps that could be cancer or another problem.

How to Do a Testicular Exam

There’s no harm in a self-exam, and doctors say it’s good to know how your testicles look and feel so you can notice any changes.

A self-exam is quick and painless. It takes only a few simple steps:

  1. Take a warm shower or bath to allow the heat to relax the skin of your scrotum.
  2. Hold your penis out of the way.
  3. Examine one testicle at a time using both hands. Roll it between your thumb and fingers.
  4. Feel for a pea-sized lump. If you see or feel something like that, contact your doctor. It’s probably nothing to worry about, but it’s important you make note of it.
  5. Check for any changes in the size, shape, or feel of your testicles. One might be of a different shape or size than the other. That’s OK, but the shapes and sizes shouldn’t change. One might hang lower than the other. That’s normal, too.

Don’t worry if you feel a cordlike structure behind each testicle. It’s a normal part of the part of the scrotum that stores and moves sperm. It’s not a lump.

Is It Testicular Cancer?

If there is a suspicious lump, your doctor might run a painless ultrasound to get a better look for signs of cancer. They might do a blood test to see if there’s an indication of cancer. If the doctor thinks it may be cancerous, they may decide to do surgery to remove the testicle and check for cancer. If it is cancerous, they can determine what kind.

Removing one testicle shouldn’t impact your sex life or your fertility, but having testicular cancer or its treatment could impact fertility. If you think you may want to have children, talk to your doctor about preserving sperm before treatment.

Here are some facts to know about testicular cancer:

It’s rare: Your chance of getting it is about 1 in 250.

It most often affects men ages 15 to 34: It’s the most common cancer in this group.

It’s highly curable: The risk of dying from it is 1 in 5,000.

Early identification is key: It’s more likely to be treated and cured if it’s found early.

Some things increase your risk: Testicular cancer generally can’t be prevented, but some things increase risk. Your risk is higher if you’re white and non-Hispanic or have an undescended testicle or a family history of testicular cancer.

Other symptoms of testicular cancer

A lump is the most common symptom, but others include:

  • Firm testicle
  • Swelling or fluid buildup in the scrotum
  • Feeling of scrotal heaviness
  • Achiness in the lower belly, groin, or scrotum
  • Breast tenderness or growth
  • Pain or uncomfortable feelings in the testicle or scrotum
  • Back pain
  • Early puberty in boys

A lump or other symptom doesn’t mean you have cancer or any other problem.

Sources

Mayo Clinic: “Testicular exam: basics.”

Cleveland Clinic: “Testicular cancer and self-exam.”

American Cancer Society: “Testicular Cancer.” “Key Statistics for Testicular Cancer.”

National Cancer Institute: “Testicular Cancer Screening – Patient Version.”

Mayo Clinic: “Testicular Exam.”

American Cancer Society: “Signs and Symptoms of Testicular Cancer,” “Fertility and Hormone Concerns in Boys and Men With Testicular Cancer.”

What is Testicular Self-Examination?

Testicular self-examination is when you check your testicles for any abnormalities. It is important to know what feels normal and to be able to notice any changes. Changes are not always cancer. If it is cancer and you catch it early, you have the best chance for a cure.

When To Perform Self-Exam

  • Boys can start these self-exams during their teens
  • Do a self-exam each month – it only takes a few minutes
  • Start right after a hot bath or shower, when the scrotal skin is most relaxed and the testes can be felt easily

How to Perform Self-Exam

  • Do the exam while standing
  • Look for swelling in the scrotum
  • Gently feel the scrotal sac to find a testicle
  • Check each testicle one at a time by firmly and gently rolling it between the thumb and fingers of both hands to feel the whole surface

Diagram of Male Reproductive Organs

Enlarge

  • It is normal for one testicle to be slightly larger than the other
  • It is normal to feel a cord-like structure (called the epididymis) on the top and back of each testicle

Check with your health care provider:

  • If you find a small, hard lump (pea size)
  • If there is swelling, pain or soreness
  • If you see or feel any other changes

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How to perform a testicular self exam

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Learn how they should feel so you can pick up on something suspicious

How to perform a testicular self exam

Finding a lump down there is one of the most terrifying things a guy can experience. But if the lump really is testicular cancer, catching it early could save your life.

Testicular cancer is one of the most curable forms of cancer, but your chances of beating it drop if it spreads before it’s diagnosed.

For example, 99 percent of men with localized testicular cancer—meaning it hasn’t spread from the testis—survive more than 5 years. But the rate drops to 74 percent once it spreads to distant organs, according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER).

Here’s how to be proactive about your own testicular health.

Should You Perform Regular Testicular Self Exams?

Currently, the U.S. Preventive Task Force recommends against routine testicular self exams.

A big part of that is because they believe that guys might be unnecessarily stressed out by finding things on the self exam that they think are harmful—but aren’t, says Tobias Kohler, M.D., a spokesperson for the American Urological Association and an associate professor of urology at Southern Illinois University School of Medicine.

It’s possible that parts of your testicular anatomy—say, your spermatic cord or epididymis, the tube that connects your testicle to your vas deferens—might feel bumpy enough to freak you out, but they are perfectly normal, says Dr. Kohler.

At your next visit with your doctor, ask him or her to point them out to you so you know what they feel like.

Once you have these structures squared away, you should be able to pick up on any potentially problematic changes in your testicles, says Dr. Kohler.

That’s why many urology experts still believe it’s smart to check your balls.

In fact, Dr. Kohler and Men’s Health urology advisor Larry Lipshultz, M.D., both recommend you examine your testicles once a month. Here’s how to get started.

How Perform a Testicular Self Exam

The best place to give your testicles a once-over is in the shower.

That’s because the warmth will relax your scrotum and make it easier for you to feel any abnormalities, says Nicholas Cost, M.D., a urologist and assistant professor at the University of Colorado.

Start at the top of your left testicle. Hold it between your thumb and fingers of both hands, and gently roll it between your fingers as you move down. Repeat on the right side.

Be on the lookout for any hard lumps, smooth or rounded bumps, or unusual changes in the size, shape, and consistency of your testicle, Dr. Cost says.

You might not be able to feel a mass itself, but it could make your testicle feel very firm.

It can be scary to find something weird, but just know that not all irregularities you find on your self exam point definitively to testicular cancer, says Dr. Kohler.

For instance, if your testicles feel like what can only be described as a bag of worms, you might have varicoceles, or enlarged veins in your testicles.

You may also find innocuous bumps that are just cysts or the result of a testicular torsion, which is a painful condition where your testicle gets twisted and swells up.

Only your doctor can know for sure, though. So if you notice a bump or lump that feels different, suddenly appears, or just worries you, schedule an appointment with your urologist right away.

Additional reporting by Paige Fowler, Joelle Smith, and Erin Weaver.

Testicular Cancer: How To Do A Self-Exam

  • Posted: Monday, June 7, 2021

Your doctor might find signs of testicular cancer during a routine checkup. But another way to find it is through self-exams.

Should you check yourself?

Some experts recommend that men perform a monthly testicular self-exam. To be clear, self-exams haven’t been studied enough to know if they actually help prevent testicular cancer deaths, the American Cancer Society (ACS) reports. That’s why groups like ACS don’t weigh in for or against them.

But self-exams are one way to get to know what’s normal for your body. That can make it easier to notice any changes you’d want to ask your doctor about.

Regular self-exams may be especially important to consider if you are at increased risk for testicular cancer. This includes people who were born with an undescended testicle and people with a personal or family history of testicular cancer.

If you have questions, ask your doctor about your testicular cancer risk.

If you choose to do a testicular self-exam, follow these steps from ACS:

1. Do it during or after a warm bath or shower. The skin will be relaxed, and it will be easier to feel any changes.

2. Check each testicle one at a time. Hold the testicle between your thumbs and forefingers with both hands, and roll it gently between your fingers.

3. Look and feel for changes. Any of the following may be unusual:

•Hard lumps.
•Smooth, round masses.
•A change in the size, shape or consistency of your testicles.

What if you find something?

First, don’t jump to conclusions. The testicles contain blood vessels and tissues that are easy to mistake for abnormal growths, ACS notes. One example is the epididymis, a coiled tube on each testicle. This can feel like a small bump on the upper or middle outer side of the testicle.

It’s also normal for one testicle to be slightly larger than the other. Or sometimes a testicle can be enlarged due to noncancerous conditions, such as a hydrocele (a buildup of fluid around the testicle).

To find out what’s going on, it’s best to tell your doctor about anything unusual you find.

Today we’re going to examine ourselves. And by ourselves, I mean our balls. Why, you may be asking, are we examining our bits and pieces today? Well, testicular cancer is the most common malignancy in young men between the ages of 20 and 34. It’s also is the number one cancer killer among men in this same age group. Who knew that the one thing two things that makes a man a man, can also be the very things that kill you?

The good news is that if detected early, testicular cancer is almost always curable. But in order to detect cancer, you need to know what to look for and also how to look for it.

Do I Need Regular Testicular Self-Exams?

Most health professionals recommend all men between the ages of 15 and 40 have regular testicular exams performed by a doctor. This is usually done once a year at your yearly physical.

If you have a history of testicular cancer in your family or if you had undescended testicles as a baby, it’s recommended that you perform monthly self-exams. Studies have shown that male children with a history of undescended testicles have about 10-40 times higher risk of developing testicular cancer. And here’s the kicker: both testes are at higher risk, not just the undescended one. If you don’t know if you had an undescended testicle, ask your parents.

The American Cancer Society doesn’t recommend that men who have no risk of testicular cancer perform regular monthly self-exams. But even if you aren’t at a high risk for testicular cancer, it doesn’t hurt to examine yourself every now and then. It’s fast, painless, and will give you peace of mind to know that everything is fine under the hood.

Today’s Task: Give Yourself a Testicular Exam

I’m sure that many of you are still trying to complete yesterday’s task and are hard at work memorizing If. So today’s task is simple, straightforward, and quick. You’re going to give yourself a testicular exam. Here’s how to do it:

It’s best to perform the exam right after a hot shower when the scrotal muscles are warm and relaxed. You know… when your balls are saggy.

1. Stand in front of a mirror and check for any swelling on the scrotum’s skin.

2. Exam each testicle with both hands by rolling the testicle gently but firmly between your thumb and fingers. Don’t worry if one testicle feels larger than the other. That’s completely normal. Fast fact: A man’s left testicle is usually larger than the right one. While you’re rolling each testicle in your hands, look for hard lumps on the surface of it.

3. Don’t confuse the epididymis for a lump. The epididymis is the spongy, tube-like structure that collects and carries your sperm to the prostate. You can feel the epididymis on the top and down the back side of each testicle. This isn’t the sort of lump you’re looking for.

4. If you notice any sort of hard lump on your testicle, don’t freak out yet. Just contact your doctor immediately. Complete and accurate diagnosis can only be performed by a trained medical physician.

Other things to look for

In addition to lumps on the surface of your testes, be on the look out for these signs of other problems:

  • Sudden acute pain during the self-examination could mean you have an infection in the epididymis or it could mean the spermatic chord is twisted up and blocking blood flow to your testicles. If you feel pain during the exam, go see the doctor.
  • You feel a soft collection of thin tubes above or behind your testicles. It’s often described as feeling like a “bag of worms.” This may indicate a varicocele.

Did you know April is Testicular Cancer Awareness month? In honor, we thought we’d go over what testicular cancer is, the symptoms and how to do a self-exam.

At many of our school cancer education outreaches , we are sometimes approached privately by young men who are concerned with some aspect of their genitalia. Something doesn’t seem right but they are not really sure what is normal.

So, along with providing information about healthy breasts and performing breast self-exams, we also provide health information about testicular self-exams, including hands-on instruction using testicular models.

What is Testicular Cancer?

While relatively rare, testicular cancer is the most common cancer in American males between the ages of 15-35. Self-exams can really pay off because testicular cancer, when detected early, has a nearly 99% survival rate.

This type of cancer occurs in the testicles, which are located inside the scrotum. The testicles produce male sex hormones and sperm.

How to perform a testicular self examPHOTO CREDIT: Male_anatomy.png: alt.sex FAQderivative work: Tsaitgaist (talk) – *[[:File:Male_anatomy.png|Male_anatomy.png], CC BY-SA 3.0, Link

How Does A Testicular Self-Examination Help?

Simple self-exam techniques can help you learn how your testicles normally look and feel so that you can become aware of any changes that happen over time. Generally speaking, the more you know about what’s normal for your body, the more likely you are to get ahead of many health issues, not just cancer. Testicular exams just take about 5 mins of your time, once a month, and can help to identify this cancer at its earliest stage.

Symptoms of Testicular Cancer

A lump or swelling on the testicle is usually the first symptom. It’s important to note that you may not have pain with this lump or swelling, but it may still be cancer.

Other symptoms include:

  • a feeling of weight in the scrotum
  • Pain or a dull ache in the testicle, scrotum or groin
  • Tenderness or changes in the male breast tissue

How To Do A Testicular Exam

The shower is the best place to perform a self-exam, since the steam relaxes your scrotum and makes it easier to feel around.

But, before you shower (or just after!) take a moment to stand in front of a mirror (best way) or just look down and check for any swelling on the scrotal skin. Here’s some tips:

  • Check one testicle at a time
  • Hold your testicle between your thumbs and fingers of both hands and roll it gently between your fingers to feel inside.
  • Most men’s testicles are about the same size, though it’s common for one to be slightly bigger than the other. It’s also common for one testicle to hang lower than the other.
  • The testicles should feel smooth, without any lumps or bumps, and firm but not hard. You may feel a soft, coiled tube at the back of each testicle, which is called the epididymis, and it is perfectly normal.
  • Normal testicles also contain blood vessels and supporting tissues. Some men may confuse these with abnormal lumps at first. If you have any concerns, ask your doctor.
  • You should not feel any pain when performing the self-exam. Be aware of any dull soreness or heaviness. The testicles should be smooth and firm to the touch.
  • MOST IMPORTANT STEP: If you notice hard lumps, smooth or rounded bumps, changes in shape, size, or consistency, contact a qualified medical professional as soon as possible. A urologist is the best type of doctor to make an accurate diagnosis, but if you feel more comfortable with your primary care provider, start with them. And if you don’t feel comfortable at all, give us a call and we will help you through this. (link to our contact/email)
  • It can be scary to find a lump in your testes! In fact, many men who find one wait several months before seeking medical assistance. This is a bad idea. Testicular cancer will not go away on its own. Remember, know health care providers—males and females—are very familiar with male reproductive anatomy and issues that come up. You don’t have to be embarrassed or scared or think that you are the only person who has this. Chances are, your health care provider deals with this on a daily basis.

For more information, including a video and simple instructions on performing testicle exams, check out these these short videos: