How is a testicular self-examination performed?

A testicular self-examination consists of performing a self-examination of the state of your testicles, in order to get used to their natural shape. In turn, various changes can be detected by touch, some of which may indicate the presence of testicular diseases. The prognosis of these diseases improves the earlier the diagnosis is made.

Why is testicular examination important?

It is important for these reasons:

  • It allows early detection of diseases, improving their prognosis and severity. An early diagnosis of testicular cancer, for example, can avoid later radio or chemotherapy. On other occasions a varicocele is diagnosed, an early treatment that avoids infertility.
  • It is a simple and inexpensive process, which does not require any type of medical instrument.

What does a normal testicle look like?

There are four structures of the testicle that should be examined differently:

  • Testicular cord, which is the one that carries the arteries and veins and the vas deferens, through which sperm are transported from the epididymis to the seminal vesicle.
  • The epididymis is an elongated and rounded structure that runs from the upper pole to the lower pole of the testicle, with a thickness of approximately a pencil. Its purpose is to collect the spermatozoa, and after a period of time where they mature, they pass into the vas deferens.
  • The testicle, which is egg-shaped. In it, the cells that form testosterone are found.
  • The Hydiates are small embryonic remains located in the testicle or epididymis. They have no function.

Conditions for testicular self-exploration

  • Be relaxed and try to carefully palpate the entire form to distinguish the shapes of the testicle.
  • The place where it is performed must have a warm temperature, since cold contracts the scrotum, tightens the testicular cord and complicates the recognition.
  • The position. In the first place, we will perform the examination standing up and then lying down. If there is a varicocele when the examination is performed standing up, the veins will be more dilated and the differences with the other testicle will be appreciated. In this position it is easier to see how far each testicle is descended.

How is testicular self-examination performed?

  • Testicular cord: the self-exploration will begin standing up, palpating the cord on each side, placing the fingers so that the cord is between the thumb in front and the index, middle and ring fingers behind, making a clamp.
    • If one of the cords is enlarged and on palpation we have the sensation that it has a series of ducts inside, it may be a varicocele. If the cord has increased in size, it increases in tension when performing an abdominal contraction, it is probably a varicocele.
    • Then slide the cord between the forceps of your fingers until you can touch the vas deferens, which is as thick as a pencil lead, hard and painless to pressure.
  • The epididymis: in this case it is an elongated structure that rests on the testicle and runs from the upper to the lower pole. To explore it, it is best to lie down. The exploration is done with both hands, sliding the fingers along its curve. Repeated manipulation causes pain.
    • The epididymis is a typical area of cysts, especially in the upper part. They are round formations that are clearly visible outside the testicle.
    • In epididymitis and orchiepididymitis, it usually thickens in size and is painful on palpation.
    • In the case of epididymal tumors, they are extratesticular, although to diagnose them it is necessary to use ultrasound. They are usually benign tumors.
  • In the case of the testicle, it should be explored using both hands, immobilizing the testicle and then squeezing it so that it moves in the fingers. The following situations can be found:
    • Testicular cancer: a deformity or lump is noted on the surface of the testicle, usually hard. It comes out of the testicle itself, and may or may not be painful.
    • Hydrocele of the testicle: it increases in size evenly and uniformly, without deformity, smooth and painless.
    • Orchitis and orchiepididymitis: the testicle and epididymis increase in size. It is a painful inflammation that can be felt hot.
    • In other processes, the testicle is smaller or even less consistent than the other. This may occur in patients with varicocele or cryptorchidism.
    • On other occasions, as in Klinefelter’s syndrome, the testicles are small and hard.
  • Hydatids: There are two Morgagni’s hydatids. One in the head of the epididymis and the other in the upper pole of the testis. As they are embryonic remains, their size is variable, from a pinhead to that of a pea. When they are small, they are palpated as a small hard dot in the epididymis or in the upper pole of the testicle. If they are larger, they can be very mobile, although they are always located in the same area.
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All men should have their testicles examined at least every two months, especially men between the ages of 20 and 40.

In addition, testicular screening is even more important in men who have had a testicular tumor, a history of cryptorchidism, microcalcifications on a testicular ultrasound, or family members with testicular cancer.

For more information, consult a Urology specialist.