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Testicular awareness

Published by Bupa's health information team, July 2008.

This factsheet is for men who would like information about being testicle aware.

Being testicle aware means knowing the look and feel of your testicles, and knowing what changes to look for.

A recent survey found that only 36 percent of men in the UK regularly check their testicles. Examining your testicles on a regular basis could help you pick up potentially life-threatening conditions such as testicular cancer at the early stages.

About testicle awareness
Screening
Testicular conditions
Further information
Related topics
Questions and answers
Sources

About testicle awareness

The testicles

The testicles are two small oval-shaped organs located inside your scrotum, the loose bag of skin that hangs below the penis. They hang outside the body. This is because one of their main functions is to develop sperm and sperm which works best at a slightly cooler temperature than the inside of the body.

Illustration showing the male pelvis
The male pelvis

An important function of your testicles is to produce sperm to form semen. Once sperm has been created in the testicles, it moves to the epididymis (a long narrow tube inside the testicle). The sperm is then stored in the epididymis for several weeks to mature. It then moves up the vas deferens (the tube that transports sperm towards the penis), where it combines with fluids from the prostate and seminal vesicles (glands on either side of your bladder), making semen.

Another vital function of your testicles is the production of testosterone (a male sex hormone). This is needed for the development of your penis, the growth of facial and body hair, muscular development and the maintenance of your sex drive (libido).

How to be testicle aware

All men's bodies are slightly different, so it's important to know the look and feel of your own testicles. Knowing what's right for you will help you spot any changes quickly.

From puberty onwards, you should check your testicles on a regular basis. The best time to do this is during, or soon after, a warm bath or shower.

Checking your testicles

Hold your scrotum in the palms of both hands. Feel the size and weight of each testicle. It's very common to have one that is larger or hangs lower than the other.
Get to know the feel of each testicle by rolling each one between your finger and thumb. They should feel smooth.
Towards the back of each testicle you'll feel a soft, tender tube - this is the epididymis. Don't confuse this with a lump - it's meant to be there.
Compare each testicle - get to know any differences between them.

Testicle changes to seek advice about

While examining your testicles, you should be looking for:

lumps in either testicle
swelling or enlargement of the testicle
an increase in firmness
pain or discomfort in your testicle or scrotum
an unusual difference between the testicles
a sudden collection of fluid in your scrotum

Other general changes to look out for are:

a feeling of heaviness in your scrotum
a dull ache in the lower part of your abdomen, scrotum or groin
a growth or sudden tenderness in your breasts

If you notice any of these changes you should see your GP as soon as possible. But remember, there's no need to panic. Most lumps are benign (non-cancerous) and having pain in your testicle doesn't necessarily mean you have cancer, there can be many causes (see Testicular conditions).

Screening

There are currently no screening programmes for testicular cancer in the UK, but self-examination is effective.

Testicular conditions

Testicular cancer

A cancerous testicular tumour is a lump created by the abnormal and uncontrolled growth of cells. It can grow and sometimes spread to other parts of your body (through the bloodstream and lymph system). This can form tumours in your lymph nodes (glands throughout your body that are part of your immune system), lungs or other organs.

Men most at risk are those aged 15 to 44. However, it's still relatively rare, and fewer than 2,000 men are diagnosed each year.

Over the past 20 years the number of men diagnosed with testicular cancer has steadily risen. Despite this, more than 95 percent of men are cured of the condition as testicular cancer is particularly sensitive to treatment. If caught early, treatment is straightforward and may only require surgery to the diseased testicle - 98% of men who have this surgery are cured.

Epididymitis

Epididymitis is inflammation of the epididymis. It's usually caused by an infection or virus. This can be the result of a urinary tract infection or a sexually transmitted infection (STI). If both your epididymis and testicle are affected it is called epididymo-orchitis.

Your testicle will be painful and swollen, and if you have severe epididymitis, you may have a fever and shivers. The skin over your epididymis will be red and warm to touch. Pain may be relieved by lifting up your scrotum. Epididymitis is usually treated with antibiotics, for at least a month, and painkillers.

Epididymal cysts

These are small lumps on the testicle caused by a blockage in the epididymis. Epididymal cysts are very common and can occur in both testicles. They can be surgically removed, but most don't need to be treated.

Hydrocele

A hydrocele is a collection of fluid in the scrotum that causes a soft, often painless swelling. It's usually caused by an injury to the testicles or an infection. If your hydrocele is large and uncomfortable, your GP may refer you to a urologist to have it drained using a needle or surgically removed. A urologist is a doctor who specialises in identifying and treating conditions of the urinary tract. If the hydrocele is small and you have no symptoms, you won't need treatment.

Varicocele

A varicocele is where the veins of your testicles become enlarged, similar to varicose veins. The main symptom is a dull ache in your testicle, especially at the end of the day or after exercise. You will also have a swelling on your testicle that is visible when you are standing up. This has often been described as feeling like a 'tangle of worms'. You may need surgery if you are in a lot of pain or if the varicocele is affecting your fertility.

Sexually transmitted infection (STI)

Some STIs, such as gonorrhoea, can cause your testicles to become inflamed, making them feel hot and swollen. STIs are usually treated with antibiotics.

Torsion

Torsion is when the testicle twists itself causing the blood supply to be cut off. Your testicle will be swollen and extremely painful. You may also have pain in the lower part of your abdomen and feel sick or be sick. Torsion is as a medical emergency, so it's very important to see your GP or go to the hospital urgently. Otherwise you may end up with permanent damage to your testicle. Torsion mostly affects men under the age of 30.

Injury

A blow or hit to your testicles can cause severe pain. This should subside, but if it doesn't or you see blood in your urine, see your GP as soon as possible.

Further information

Orchid
0207 601 7167
www.orchid-cancer.org.uk
Men's Health Forum
www.menshealthforum.org.uk