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A testicular self-examination (TSE) is the procedure by which a man checks the appearance and consistency of his testes.
Most testicular cancers are first noticed by the man himself. Men should do a TSE every month to find out if the testes contain any suspicious lumps or other irregularities, which could be signs of cancer or infection.
A TSE should take place during a warm shower or bath, when the skin is warm, wet, and soapy. The man needs to step out of the tub so that he is in front of a mirror. The heat from the tub or shower will relax the scrotum (sac containing the testes) and the skin will be softer and thinner, making it easier to feel a lump. It is important that the exam be done very gently.
The man should stand facing his mirror and look for swelling on the scrotum. Using both hands, the scrotum should be gently lifted so that the area underneath can be checked.
The next step is examination by hand. The index and middle fingers should be placed under each testicle, with the thumbs on top. The testes should be examined one at a time. The man should roll each testicle between his fingers and thumbs. He should feel for lumps of any size (even as small as a pea) particularly on the front or side of each testicle. He should also look for soreness or irregularities. Next, the epididymis and vas deferens, located on the top and back of the testes, should be felt. This area feels like a cord, and should not be tender.
It is normal for one testicle to be larger than the other is, and for them to hang at different levels; but the size should stay the same from one month to the next. The testes should be free from lumps, pain, irregularities and swelling.
A TSE is considered abnormal if any swelling, tenderness, lumps, or irregularities are found. Hard, unmoving lumps are abnormal, even if they are painless. A lump could be a sign of an infection or a cancerous tumor. A change in testicle size from one month to the next is also abnormal. A feeling of heaviness in the scrotum is another abnormal sign. If any abnormality is found, a man is encouraged to check with his doctor as soon as possible because testicular cancer is highly curable if found early.
Hainsworth, John D., and F. Anthony Greco. "Testis." In Cancer Treatment, edited by Charles M. Haskell, 5th ed. Philadelphia: W.B. Saunders, 2001.
Seidel, Henry M., et al. Mosby's Guide to Physical Examination. 4th ed. St. Louis: Mosby, Inc., 1999.
"Questions and Answers About Testicular Cancer." National Cancer Institute. February 2000. http://cis.nci.nih.gov/fact/6_34.htm.
Epididymis — A tube in the back of the testes that transports sperm.
Scrotum — The pouch containing the testes.
Testes — Egg-shaped male gonads located in the scrotum. Testes is the plural form of testis, which is a testicle.
Vas deferens — A tube that is a continuation of the epididymis. This tube transports sperm from the testis to the prostatic urethra.
tes·tic·u·lar self-ex·am·i·na·tion(TSE) (tes-tik'yū-lăr self'eg-zam'i-nā'shŭn)
Procedure for detecting tumors and other abnormalities in the testes.
A technique that enables a man to detect changes in the size and shape of his testicles and evaluate any tenderness. Each testicle is examined separately and in comparison with the other. The best time to perform the test is just after a warm bath or shower when the scrotal tissue is relaxed. The man places his thumbs on the anterior surface of the testicle, supporting it with the index and middle fingers of both hands. Each testicle is gently rolled between the fingers and thumbs and carefully felt for lumps, hardness, or thickening, esp. as compared with the other testicle. The epididymis is a soft, slightly tender, tubelike body behind the testicle. Abnormal findings should be reported immediately to a health care professional.