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Testicular self-examination is an examination of the testicles. The testicles (also called the testes) are the male reproductive organs that produce sperm and the hormone testosterone. They are located in the scrotum under the penis.

Perform this test during or after a shower. This way, the scrotal skin is warm and relaxed. It's best to do the test while standing.

1. Gently feel your scrotal sac to locate a testicle.
2. Hold the testicle with one hand while firmly but gently rolling the fingers of the other hand over the testicle to examine the entire surface.
3. Repeat the procedure with the other testicle.

A testicular self-exam is done to check for testicular cancer. Normal testicles contain blood vessels and other structures that can make the exam confusing. Performing a self-exam monthly allows you to become familiar with your normal anatomy. Then if you notice any changes from the previous exam, you'll know to contact your doctor.

You should perform a testicular self-exam every month if you have or have had any of the following risk factors:

1. Family history of testicular cancer
2. Previous testicular tumor
3. Undescended testicle
4. Are a teenager or young adult (to about 35 years old)

Each testicle should feel firm, but not rock hard. One testicle may or may not be lower or slightly larger than the other.

Always ask your doctor if you have any doubts or questions.

If you find a small hard lump (like a pea), have an enlarged testicle, or notice any other concerning differences from your last self-exam, see your doctor as soon as you can.

Consult your doctor if:

• You can't find one or both testicles -- the testicles may not have descended properly in the scrotum
• There is a soft collection of thin tubes above the testicle -- it may be a collection of dilated veins (varicocele)
• There is pain or swelling in the scrotum -- it may be an infection or a fluid-filled sac (hydrocele), causing blockage of blood flow to the area

Sudden, severe (acute) pain in the scrotum or testicle is an emergency. If you experience such pain, seek immediate medical attention.

A lump on the testicle is often the first sign of testicular cancer. Therefore, if you find a lump, see a doctor immediately. Keep in mind that some cases of testicular cancer do not show symptoms until they reach an advanced stage.

Shaw J. Diagnosis and treatment of testicular cancer. Am Fam Physician. 2008;77(4):469-474, 475-476

U.S. Preventive Services Task Force. Screening for Testicular Cancer: Recommendation Statement. Rockville, MD: Agency for Healthcare Research and Quality; February 2004.

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.