Apr 232011

Time for another type of self-exam: testicular self exams (TSEs)

The American Cancer Society currently has no recommendations regarding testicular self exams – they say there aren’t enough data regarding their effectiveness. Some doctors, however, still recommend monthly self exams starting around age 14. Like breast exams, they:

  • Are a great way to get to know your body (especially for those of you who are going through body changes, or haven’t learned your body)! You’re better able to catch any changes, which you can then discuss with your doctor. Partner(s) can also be involved in exams, which can help keep them from getting boring.
  • Can lead to false positives (thinking that there’s something seriously wrong when there isn’t), which can be stressful and costly, and false negatives (thinking there’s nothing wrong when there is), which can be fatal.

Anyone with balls (testicles) can do a TSE — anyone else must examine someone else’s. Women, transmen, and anyone who has had an ochiectomy don’t have to do TSEs because they don’t have balls – they’re not at risk for testicle-related problems. Folks who are on the receiving end of cock and ball torture (warning!: graphic images) may especially wish to do TSEs to monitor for changes.

The timing of a TSE is not especially important. Some physicians say it should be monthly, but there isn’t a consensus that I’m aware of. Pick a day at a regular interval and stick to it!

How to do a TSE:

  • It’s best to do a TSE right after (or during) a warm bath or shower. The warmth relaxes the skin of the scrotum, making it easier to feel the inside bits (there’s no thickly bunched wrinkly skin in the way!).
  • Using both hands, gently feel one testicle at a time. Roll it between your fingers – how does it feel? Any unusual lumps or bumps? Does it feel different than usual, or does it hurt? Make sure you feel all of both testicles.
  • Take a look at the skin of your scrotum. Any unusual bumps or swelling?
  • Make sure you mention any changes to your doctor.
  • That’s it! Kids Health, The Testicular Cancer Resource Center, and the American Cancer Society all have guides too if you need them.

What are you feeling? (Warning: all the links in this section have explicit images.)

  • The American Cancer Society has a nicely simplified diagram.
  • The scrotum usually contains two testicles, plus a bunch of blood vessels and nerves (which you might be able to feel). Each testicle has an epididymus and a ductus deferens (aka vas deferens). The epididymus is a highly coiled tube-like structure that sits on the top and back of the testicle. The ductus deferens is also a tube, going from the epididymus up into the body, where it eventually connects with the urethra.
  • Testicles make sperm. The sperm enter the epididymus, where they’re stored and finish developing. During ejaculation, the sperm go whizzing out of the epididymus into the ductus deferens, into the urethra, and out the tip of the penis (along with other fluids that are added along the way).
  • It’s perfectly normal for testicles to be different sizes or to hang at different heights.
  • If you need help figuring out what’s what, and what’s normal,  ask your doctor.

If you find something during a TSE, don’t panic. It probably isn’t cancer. There are lot of other things it could be – some potentially bad, others not so much. You do need to mention it to your doctor just in case.

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