Testicular Examination and Testicular Self-Examination (TSE)

Each testicle should feel firm but not hard, and the surface should be very smooth, without any lumps or bumps. The spongy, tube-shaped structure (epididymis) may be felt on the top and down the back side of each testicle. One testicle (usually the left) may hang slightly lower than the other, and one testicle may be slightly larger than the other. This difference is usually normal.

No pain or discomfort is experienced during testicular examination or TSE.

A small, hard lump (often about the size of a pea) is felt on the surface of the testicle, or the testicle is swollen or enlarged. If you notice a lump or swelling during TSE, contact your doctor immediately. Do not delay or wait for the lump to go away, because it may be an early sign of Reference testicular cancer Opens New Window. Immediate treatment provides the best chance for a cure.

One or both testicles are not felt. If you cannot feel one or both testicles while performing TSE, contact your doctor. This may mean an Reference undescended testicle Opens New Window.

A soft collection of thin tubes (often referred to as a "bag of worms" or "spaghetti") is felt above or behind the testicle. This may mean a Reference varicocele Opens New Window.

Sudden (acute) pain or swelling in the scrotum that is noticed during the testicular examination or TSE may mean an infection (Reference epididymitis Opens New Window) or blockage of blood flow to the testicle (Reference testicular torsion Opens New Window), either of which requires immediate medical evaluation.

A free-floating lump in the scrotum that is not attached to a testicle may be present but is not a cause for concern.