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A man examines his testicles.
Testicular self-examination is a medical practice by which external feeling of the testicles can act as a first-warning for testicular cancer.
The testicular self-exam (TSE) is done at home in an effort to screen for testicular cancer (secondary prevention). International literature shows many men do not know how to perform screening for testicular cancer through a self-exam. TSE is recommended to be done while standing and after a warm shower when the scrotum is relaxed and the testes are lower.
Abnormal results of the TSE include the following:
- a lump in one testicle
- Pain or tenderness in testicle, possibly feeling of fullness or pain in the scrotum, penis, or groin/abdomen
- build-up of fluid in the scrotum
- a change in the size of one testicle or the relative sizes of the two (it can be normal for one testicle to be slightly larger, or hang lower than the other)
Some signs and symptoms of testicular cancer found during the TSE are common to other disorders of the male urinary tract and reproductive organs, some of which require prompt medical attention to preserve reproductive and urinary function. These include hydrocele testis, a varicocele, a spermatocele, genitourinary system cancers, urinary tract infections, sexually transmitted infections, or testicular torsion.
Evidence and Practice
Practitioners may recommend testicular self-exam (TSE) when the following risk factors are present:
- Family history of testicular cancer
- Past testicular tumor
- Undescended testicle
- Testicular Atrophy
However, there is no medical consensus for recommendations on TSE. It is not clear that TSE without presenting symptoms would decrease risk of dying from testicular cancer. Although the intent of screening is to decrease mortality and increase quality of life, the benefit of TSE is uncertain; thus, the US Preventative Services Task Force and the Royal Australasian College of General Practitioners recommend against routine screening while the American Cancer Society recommends TSE for men over the age of 20, and the European Association of Urology recommends TSE for men with risk factors.
Testicular self-examination has generally low rates of practice in part because males are poorly informed, but also because of psychological aversion. Comparatively woman are more diligent in performing breast self-examination than men. A person's likeliness to perform self-examination is related to their fear of developing cancer. In addition to sex there is some reason to believe that socioeconomic factors also relate to frequency of examination.
Sometimes, if a young adult male has a spouse or partner, the spouse/partner will perform or assist in the exam, which can be done as a form of sex play and/or foreplay. The spouse or partner often is the one that spots testicular changes without formal screening.
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