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Testicular Self-Exam

Testicular self-exam, or TSE, is a painless, simple and very important monthly procedure for early detection of testicular cancer. Men who have an undescended or partially descended testicle are at a much higher risk of developing testicular cancer.

The first sign of testicular cancer is usually a slight enlargement or change in the consistency of the testicle. Small lumps, about the size of a pea, may be initially painless. As they grow larger, however, the testicle becomes firmer and you may notice a dull ache in the lower abdomen or groin, or a sensation of heaviness.

Although most lumps are non-cancerous, be sure to report any inconsistency to your doctor immediately. Cancer is most common in men aged 20-35. Regular self-examination for testicular changes can lead to early diagnosis and effective treatment.

A testicular self-exam (TSE) should be performed after a warm shower or bath when the skin of the scrotum is most relaxed. The heat causes the skin to relax, making the exam easier. Examine both testicles regularly, at least once a month.


Anatomy of the Scrotum

The testes (singular, testis) are two glandular organs located within the scrotum that produce sperm and male hormones. Each testis is egg-shaped, and a tubular structure called the epididymis is situated along its back portion. At its lower end, the epididymis connects to a longer tubular structure called the vas deferens (seminal duct) that leads to the prostate gland.

The epididymis collects sperm produced in the testis. The sperm then travel up the vas deferens to the prostate gland in the seminal fluid. There, secretions are added which aid sperm motility (ability to move about), producing semen. Semen is released from the prostate gland into the urethra, through which it exits the body during sexual intercourse.


TSE Technique
  • Try placing your right leg on a chair while you examine the right testicle, and then elevate the left leg to examine the left testicle.
  • Cup scrotum with one hand and note any changes
  • Check each testicle one at a time
  • Gently roll testicle between your fingers and thumb


Testicles
  • Normal testicles are smooth and spongy.
  • One testicle may be larger than the other
  • Left testicle may lie lower than right
  • Testicle is normally oval shaped
  • Testicle should be firm, smooth, and rubbery

Epididymis
  • Examine the epididymis, the sperm-carrying tube that runs up from your epididymis.
  • It is a rope-like structure on the top and back of the testicle.
  • Learn to feel the normal ropelike, tubular feel of the epididymis.
  • The epididymis should be soft and mobile.
  • This structure should not be confused with a lump, which is usually a firm area on the front or side of the testicle.

Vas deferens
  • Examine the vas deferens (spermatic cord), which is next to the epididymis.
  • The vas normally feels like a firm, movable smooth tube.

Call your doctor if you:
  • If there is any new enlargement of one of the testes.
  • If you have a heavy sensation in testicles or groin.
  • If you develop a dull ache in lower abdomen or groin.
  • If you are unsure that you have found a lump.
  • If you have any questions or concerns.


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