How to perform a testicular self-examination

According to Cancer Research UK, the rate of testicular cancer has increased by 24% since the 1990s. Testicular cancer is one of the less common cancers and tends to mostly affect men between 15 and 49 years of age, according to the NHS UK website.

Just as it’s recommended that women check their breasts on a monthly basis, men should also be performing a self-examination of their testicles (balls) on a regular basis. Checks can help you become familiar with your body and recognise any changes sooner.

If you’ve never ‘checked your chaps’, it’s not too late to start. This Men’s Health Week (14-21 June 2021), learn how to perform a five-minute testicular check.

Check your testicles in these three simple steps

To perform the exam, stand nude in front of a mirror after a warm bath or shower.

  1. Check for swelling: hold the penis out of the way and look at the skin of the scrotum. You may see bumps which seem unusual, but these are not necessarily a sign of cancer. Bumps can be caused by ingrown hairs, rashes or other skin-related problems
  2. Roll each testicle: using your thumb and forefingers, gently roll each testicle in turn, looking and feeling for any changes. These include lumps, bumps or changes in shape or size
  3. Check again: make sure you ‘check your chaps’ on a regular basis. Add a monthly reminder in your diary, phone or calendar to give you a nudge

At the back of your testicles you may also feel a softer, bumpier tissue which feels different to the testicle it’s attached to. These tubes are called the epididymis and are a normal part of the male reproductive system. They can easily be mistaken for an unusual mass if you’re unfamiliar with them.

What should my testicles feel and look like? 

The vast majority of men’s testicles are about the same size, though it's common for one to be a bit larger than the other, as well as one hanging lower than the other.

Your testicles should feel fairly smooth, without noticeable lumps or bumps. They should be relatively firm but not hard. Around the back of your testicles, you can feel a soft tube which is called the epididymis.

The best place to notice any changes to your testicles is during a hot shower, as the heat causes the testicles to hang lower, making them easier to examine. 

What causes swelling or lumps in the testicles?

There are a few different causes of testicular swelling or lumps;

  • Epididymal cyst– lump(s) caused by a collection of fluid in the epididymis
  • Varicocele– enlarged veins in the testicles.
  • Testicular torsion – a sudden and painful swelling that occurs when a testicle is twisted, requiring medical attention as soon as possible
  • Hydrocele– swelling caused by fluid
  • Epididymitis – Chlamydia infection located in the epididymis which can cause inflammation. This often leads to swelling, tenderness and redness on the scrotum (ball sack)
  • Testicular cancer – an estimated 4 in 100 testicular lumps are cancer, so this is an uncommon cause of lumps. However, it is the most severe and - should you identify a lump on your testicle - you should contact your GP

Types of testicular cancer

The different types of testicular cancer are classified by the type of cells the cancer begins in.

According to NHS UK, the most common form of testicular cancer (95% of all cases) is germ cell testicular cancer. Germ cells are a type of cell that the body uses to create sperm. This form of testicular cancer has two ‘subtypes’ which both respond well to chemotherapy, they are:

  • Seminomas – around 45% of all testicular cancers
  • Non-seminomas – around 50% of all testicular cancers

Other, less common types of testicular cancer include: Leydig cell tumours and Sertoli cell tumours.

What are the different signs of testicular cancer?

Testicular cancer is luckily easy to identify, it’s important that you get checked out by a doctor if you notice any of these changes, so look out for one or more of the following signs:

  • Swelling or unusual enlargement, or a change in shape of a testicle
  • A hard lump on the front or side
  • An unusual and noticeable difference between one testicle and the other
  • Increased firmness of the testicle

Testicular cancer is far easier to treat in the early stages, so it’s essential to check them on a regular basis to ensure that no changes go unnoticed.

If you notice any unusual changes in the way your testicles look or feel, you should contact your GP.

We offer treatment for conditions related to your testicles in a comfortable and reassuring environment. Find out more about our urology treatments by completing our online enquiry form or by contacting our Private Patient Team on 01580 363158.

Published on 14 June 2021