Testicular exam

Overview:

A testicular examination is a self-examination procedure. It is the process of seeing visually and examining the testes with one’s own hands. This helps to identify any visible changes in the testes and its surrounding tissues. One can physically examine the testes and their surrounding areas to detect any lumps or growths on the testes and their surrounding areas. One can meet the healthcare professional (HCP) when there is a suspicion after a self-exam. 

Anatomy:

Testes are reproductive organs in males. They are a pair of organs located on the right and left sides of the body. They are not visible clinically but can be felt as large oval or round structures when palpated. They are enclosed in a pouch called the scrotum that holds them in place 

The right and left testes are connected by a thin cord-like structure called the spermatic cord that has nerves, blood vessels, and tubes. Both the right and left testes vary in their size and it is common to have one testes slightly larger than the other. Testes are made of several lobes connected by small tubes inside them.

The function of the testes:

Testosterone is the male hormone that induces the development of secondary sexual characteristics at puberty. Testosterone is the main male hormone that induces the development of secondary sexual characteristics at puberty. This is important for male fertility, sexual desire, muscle mass, and other male characteristics. Sperm when it unites with the egg of a female produces a baby. 

Anomalies of testes:

Some of the common disorders that affect the testes include:

• Cryptorchidism is a condition where the testes do not drop into the scrotum. 
• Polyorchidism is a condition where there may be more than two testes.
• Transverse Testicular Ectopia occurs when both the testes descend on the same side of the scrotum.  
• Orchitis is the inflammation of the testes that causes pain and swelling.
• testicular torsion causes rotation of the testes in the scrotum decreasing the blood supply to it. 
• Lumps or growths on the testes that can cause testicular cancer
• Spermatocele is a cyst that grows behind the testes

Testicular self-exam (TSE):

Testicular self-exam is a step-by-step procedure of observing, feeling, and noting any abnormalities in the testes. It is done to identify any early changes in the size, shape, and form of the testes. It helps males to protect themselves from testicular cancer which is the most common cancer in males. 

Indications:

Testicular examination is done to identify any abnormalities in the testes. This includes knowing how they look and feel normally and also being able to identify the abnormality. TSE is indicated in individuals who are born as males and between the ages of 15-35 years. One can perform the TSE every month to identify any abnormality. A testicular examination is indicated in:

• Infections of testes
• Swelling of the testes leads to the development of cysts.
• Abnormal growths on the testes that can lead to testicular cancer.

Testicular cancer is a common cancer in males. Self-examinations do not reduce the risk of death, but they help in the early identification of the disease. Early detection can help early treatment which can increase the quality of life of an individual. 

Advantages:

Testicular examination has many advantages.

• It is a basic self-test that can be done privately at one’s comfortable place.
• It does not need any equipment and takes very little time. 
• It helps in early detection of any diseases or abnormalities.
• It helps to understand the body's anatomy.

Self-examination procedure:

While doing a testicular examination, an individual should wash their hands and stand in front of the mirror without any clothes. One can examine after a warm shower as it helps to relax the testes and scrotum. 

No preparation is needed before doing the examination. Any shaving before the examination can hurt the testes or scrotum. Peeing before the examination helps an individual to perform the self-exam without any urgency. 

• Inspect the skin of the scrotum for any bruises, cuts, ulcers, or infections and observe for any color changes or swellings on the skin of the scrotum. 
• Palpation is done by lifting the penis to locate the testes. Then, by using both hands palpate the testes by placing the index and middle fingers under the testes and thumb on the top of the testes. Slowly move the testes between the fingers and observe any changes in the size, shape, or texture of the testes. Feel the testes from the top to the bottom. 

Testes should feel smooth and firm to touch on palpation. One should not have pain or tenderness while examining the testes. One can also identify the cord that connects the two testes. Compare the testes on both sides. 

After the self-exam:

TSE does not take much time. It takes only a few minutes to conduct the test. Wash hands and wear clothes. If any abnormality is suspected visit the HCP. If no abnormality is detected, one can continue their daily activities. 

Results:

If an individual finds a lump or swelling further investigations have to be carried out under the guidance of the HCP. These include a transillumination physical test, a few blood tests, an ultrasound, and a biopsy. TSE should not be a replacement for the examination done by an HCP. One has to get a testicular examination done by an HCP regularly. 

Risks:

TSE is not associated with any risks or complications. However, one can be subjected to unnecessary tests if they are concerned about normal growths too. 

Conclusion:

A testicular self-exam is an examination done by an individual on oneself. This helps to understand the body's anatomy better and identify any abnormality sooner. It helps in the early detection of testicular cancer. 

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