Definition
Testicular self-examination is a procedure in which men examine their own testes physically (feel) and visually (look) to identify any changes to detect scrotal abnormalities such as varicoceles and testicular tumor at the earliest.
Purposes
- To detect testicular tumors.
- To identify the scrotal abnormalities (e.g., varicoceles).
Indications
- Routine examination after puberty.
- Any lump or painless swelling in the testes.
- Family history of testicular cancer.
- History of undescended testis or previous testicular tumor.
- Discharges from the penis.
- After orchiectomy.
Articles
| Articles | Purposes |
| Mirror | To inspect the testes. |
| Screen | To maintain privacy. |
| Clean gloves (optional) | To prevent infection and contamination. |
Procedure
| Nursing action | Rationale | |
| 1. | Explain the procedure to the patient, provide privacy, and ask the patient to disrobe completely and to put on a gown. | Obtains patient’s cooperation and provides easy access while maintaining maximum privacy. |
| 2. | Wash hands and apply clean gloves. | Practices clean technique. |
| 3. | Instruct the patient to stand up and fold up his gown to expose the genitalia. | Provides best exposure for examination. |
| 4. | Advise the patient to use both hands to palpate the testes. Roll the testes between the thumb and first three fingers until the entire surface has been covered. Palpate each testis separately. The normal testicle is smooth and uniform in consistency. Note the size, position, shape, consistency, and tenderness. Explain that it is normal to find that one testis is larger than the other. | The left testicle normally sits lower than the right testicle. The testes lie freely in the scrotum, are oval shaped, and measure 4-5 cm in length, 3 cm in width, and 2 cm in thickness. Pressure on testes normally produces a deep visceral pain. Twisting or torsion of the testes causes venous obstruction, edema, and eventually arterial obstruction. |
| 5. | Advise the patient to hold his scrotum in the palm of his hands so that the thumb, index, and middle fingers are free. With the thumb on top of the testicle and fingers below, roll each testicle between them. Advise the patient to palpate each testis one at a time and feel for any evidence of a small, pea-sized lump or abnormality. Check for lumps, irregularities, pain in the testis, or a dragging sensation. Cup one testicle at a time using both hands best performed during or after a warm bath or shower. Examine by rolling the testicle between thumb and fingers use slight pressure. Familiarize yourself with the spermatic cord & epididymis tube like structures that connect on the back side of each testicle. Feel for lumps, change in size or irregularities. It is normal for one testis to be slightly larger than the other. | |
| 6. | Teach the patient to locate and palpate the spermatic cord and vas deferens between the thumb and fingers (from epididymis to the inguinal ring). | To note any nodules or swelling. |
| 7. | Standing naked in front of a mirror, observe the size and shape of scrotum for swelling or any other abnormality. | To visualize any changes in the external appearance of the scrotum. |
| 8. | Assist the patient to a comfortable position. | Provides more comfort for the patient. |
| 9. | Review the steps and ask the patient to demonstrate testicular self-examination. | Evaluates success of teaching given. |
| 10. | Remove gloves and wash hands. | Reduces risk of transmission of microorganisms. |
| 11. | Give the patient written material if available. | Reinforces teaching. Provides a readily available form to the patient for reference at home. |
| 12. | Notify the healthcare provider at once if any abnormalities are found. | Facilitates early initiation of treatment regimen. |
| 13. | Record date, time, findings of palpation, and patient’s response to findings and teaching. | Serves as a legal document and prevents duplication. |
Special Considerations
- Start self-exams around age 15, as testicular cancer is most common in young adults.
- Use both hands to gently roll each testicle between your fingers.
- Feel for lumps, swelling, or changes in size—testicles should be smooth and firm.
- Identify the epididymis, a soft tube at the back of the testicle, to avoid mistaking it for a lump.
- Hard lumps, swelling, or pain may indicate a problem and should be checked by a doctor.
- One testicle slightly larger or lower than the other is normal.
- If you notice persistent changes, seek medical advice promptly.
- Athletes – Protective gear can reduce injury risks but does not replace regular self-exams.
- Men with Undescended Testicles – Higher risk of testicular cancer; self-exams are crucial.
- Family History of Testicular Cancer – Increased vigilance is recommended.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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