Testicles are a pair of oval-shaped organs held with a sac of skin, called the scrotum. The scrotum hangs outside of the body, because the testicles need to be keep slightly cooler than body temperature.


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Testicles are a pair of oval-shaped organs held with a sac of skin, called the scrotum. The scrotum hangs outside of the body, because the testicles need to be keep slightly cooler than body temperature.

When it comes to your nuts, do you know what’s normal? If not, it’s time to get hands on, with our run-down of testicle health tips and advice. Most men’s testicles are a similar size, although it’s common for one to be slightly lager than the other and one testicle often hangs lower than the other. But what should healthy testicles look and feel like, how can you tell if something amiss, and what happens if you lose a testicle?

Male cancer information nurse Rob Cornes, answers your key testicle health questions to mind your mind (and your balls) at ease:

How do testicles work?

Testicles are a pair of oval-shaped organs held with a sac of skin, called the scrotum. The scrotum hangs outside of the body, because the testicles need to be keep slightly cooler than body temperature. The testicles are responsible for producing and storing sperm, and also for creating testosterone and other male hormones (androgens).

What do healthy testicles look and feel like?

When checking your testicles, they should feel smooth and firm, but not hard, and they should be roughly the same size. However, it’s perfectly normal for one to be a little larger than the other, and also for one to hang lower than the other.

How to check your testicles

It’s important to check your testicles regularly, to get to know what feels normal for you. Carry out the following self-examination guide regularly:

  • The best time to check your balls is either during or shortly after you’ve had a bath or shower, as your testicles will be warm and relaxed.
  • Examine one ball at a time by taking the testicle between your thumb and first two fingers and rolling with consistent gentle pressure.
  • Rest your testicles in the palm of your hand and gently use your thumb and fingers to feel them.
  • Check for any lumps or changes in shape, size or consistency.
  • Be aware of the small tube which lies behind each testicle called the epididymis. This should feel rope-like and tender to pressure.
  • Don’t worry if one’s bigger or hangs lower – this is normal!
  • If you notice a change or you feel a lump, don’t panic. Most lumps are not cancerous. If you do notice anything unusual, make an appointment to see your doctor as soon as you can. If caught early enough testicular cancer is highly curable.

Found a suspicious lump on your balls or something feels amiss? ‘If in doubt, get checked out,’ says Cornes. ’96 per cent of conditions that may affect the area around the testicles are not cancer.’

‘Anything that doesn’t feel right should be checked out,’ he adds. ‘Common conditions can usually be easily detected by a GP. If they can’t, then an ultrasound scan can be performed to identify the problem.’

Testicle cysts vs cancerous lumps

If you’ve noticed an unusual lump or bump in your scrotum, it’s important to get it checked out by your doctor, but Cornes says try not to worry.

‘Epididymal cysts usually occur at the top of the epididymis, separate from the testicle,’ explains Cornes. ‘They’re relatively easy to distinguish from a tumour. They are filled with fluid and are soft to feel, whereas testicular cancer is usually a hard lump. The cysts can vary in size, from as small as a pimple to the size of a testicle or even a grapefruit.’

Testicle cysts treatment

The cyst will normally be diagnosed with a simple examination by your GP. ‘Because they contain fluid, a light will shine through them,’ explains Cornes. ‘But if there is any doubt, an ultrasound can be performed.’

Your GP may or may not advise treatment for a cyst, depending on your symptoms. ‘Cysts won’t go away on their own, but they can be removed with a simple operation, normally under a local anaesthetic,’ says Cornes. ‘But unless they are uncomfortable, doctors usually recommend that they are left alone. If the cyst is infected, it is normally drained in an outpatient procedure.’

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Other causes of testicle lumps and bumps

As well as cysts, other causes of non-cancerous lumps and swellings may include the following:

• Inguinal hernia

When part of the small intestine pushes through a small opening in your abdominal wall and down into your scrotum. Symptoms include swelling, bulging, aching and heaviness.

• Varicocele

Similar to varicose veins, this is a collection of swollen veins in the scrotum.

• Epididymitis

Infection of the epididymis, just above the testicle, usually caused by an STI, such as chlamydia.

• Testicular torsion

The twisting of a testicle in the scrotum, which can inhibit blood supply and nerve function. This can result in severe pain and swelling, and is considered a medical emergency.

Testicular cancer symptoms

Concerned there might be something seriously wrong in the testicle department? Other symptoms of testicular cancer may include the following:

  • A hard, pea-sized lump – although it may be larger
  • An ache or pain in the testicles
  • A ‘heavy’ feeling in the scrotum
  • Back pain caused by enlarged lymph nodes
  • Swelling of the breast tissue – although this is rare

Testicular cancer treatment

While the ‘C’ word is scary, Cornes reassures that, if diagnosed, you have every chance of making a good recovery from testicular cancer.

‘Testicular cancer is very treatable and, in most cases, curable,’ he says. ‘Treatment usually involves removing the affected testicle, but providing the other testicle’s healthy, fertility shouldn’t be affected.

‘Chemotherapy may be needed in some cases, which can cause temporary infertility, but men are always given the chance to store sperm before treatment, which if needed, can be used at a later date.’

What happens if you lose a testicle?

If you have one or both testicles removed due to cancer, there will obviously be implications, although when it comes to your balls, one is generally as good as two.

‘Around 90 per cent of the male sex hormone, testosterone, is produced by the testicles,’ explains Cornes. ‘Testosterone is the hormone responsible for secondary male characteristics, such as muscle, bone growth, hair pattern, deep voice and a general feeling of well-being in men. It is also responsible for sperm growth. Having one testicle removed should not affect the overall testosterone levels, sex drive or ability to have an erection or fertility. Providing that the remaining testicle is healthy, it should do the job of both.

‘Men who lose both testicles are likely to have erection problems, due to the reduced levels of testosterone. They will also be unable to father a child naturally.

‘When testosterone levels are minimal, men will often experience a loss of libido, well-being and may experience lethargy, low mood and depression, weight gain and sometimes breast swelling. In this situation, testosterone replacement therapy will be needed. This can be administered in the form of injections, gels or patches, but may take some weeks for levels to normalise.’

For more information, visit orchid-cancer.org.uk or call the National Male Cancer Helpline on 0808 802 0010.

Last updated: 22-10-19

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