In the male reproductive system there are 3 main structures affected by disease: Testicle. Epididymis: a channel located posteriorly along each testicle, continuing afterwards into the vas deferens. Spermatic cord: connects the testicle to the abdominal cavity and includes the vas deferens and the tissues that surround it. Diseases affecting these structures cause signs and symptoms that in many cases can be detected by palpation . Self-exam or testicular palpation is useful to identify alterations that contribute to the early diagnosis of potential problems and to the success of their treatment. Doing self-examination regularly makes each man know his own anatomy better and better and thus to detect any deviation from normal more easily than anyone else. When should testicle self-exam be done? Testicle auto-exam performed by each man should be done: Once a month; From adolescence; In an orthostatic position, that is, standing up; During or after a hot shower, for the scrotum to be more relaxed and the testicles to be lowered. It can be performed at any other convenient time, the important thing is that it is always under similar circumstances. How do you do a testicular self-exam? Testicle palpation is done for the left and right testicle individually. Examine each testicle with both hands; Hold the testicle between the index, middle and ring fingers (together) and the thumb of each hand; Roll the testicle and the epididymis that adheres to it between the fingers; Is it normal that: Palpation does not cause pain; The surface of the testicle is regular and its consistency is firm, similar to that of a boiled egg; One testicle is slightly larger and/or lowered further than the other; The testicles are lowered when the temperature is higher and closer to the body when it is cold, this is part of the temperature regulation mechanism that protects sperm production and survival; Feel the epididymis on palpation, as it runs through the entire height of each testicle; Feeling other structures that are normal, with practice you will recognize them better. When changes are detected Always seek medical care when a self-exam identifies changes, so that the situation is clarified. Ask your family doctor for advice or make an appointment with a urologist . Any irregularity, lump or hardening should be considered abnormal. However, not all alterations identified in the self-exam mean disease. Many diseases that cause testicular changes are benign. Sometimes, especially when there is not much practice, normal anatomical structures are misinterpreted and understood as alterations. For example, there are cases in which the head of the epididymis is more prominent and is more detached from the upper pole of the testicle and is interpreted in the self-exam as a nodule, being in fact a normal structure. Changes identified in the self-exam are always first confirmed by testicular palpation performed by the urologist. It is almost always necessary to also confirm palpation findings with an ultrasound study, which as a rule is immediately accessible in urologists consultation offices. The treatment to be carried out depends on the diagnosis. In some cases, it may involve surgery. Testicular cancer and benign diseases The main disease that can be identified in testicular palpation is testicular cancer . Due to it seriousness, the small effort of doing a self-exam regularly is more than justified. Testicular cancer is a rare disease, but it mainly affects men between 20 and 50 years of age. When testicular cancer is diagnosed early, its cure rate is high, over 90%. In most cases, testicular cancer presents itself as: A hardened irregularity of the testicular surface; A hardened enlargement of the organ; A nodule or lump localized to or completely involving the testicle. There are benign diseases much more common than testicular cancer , for example: Cysts in the epididymis or spermatic cord; Lipomas, which are benign tumors of adipose (fat) tissue; Varicose veins, which affect almost exclusively the testicular cord on the left; Hydrocele, which is an accumulation of liquid in the scrotum and can increase its volume and by a soft and squeezable consistency or by the perception of being globally hard. Benign diseases eventually detectable on testicular palpation usually have an extra-testicular location. Anything intra-testicular is more worrisome. The important thing is to diagnose problems early because the success of their treatment is much greater. For this, t esticle self-exam performed regularly plays a decisive role . Author : Carlos Guimarães Meet the urology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
