Testicular Self Examination

TSEA testicular self-examination (TSE) is useful

in the detection of cancer of the testicles.

Testicular cancerTesticular cancer is the most common solid

tumor found in males age 20-34 years. If detected early and treated, testicular cancer is almost 100% curable. If untreated, it may spread to the lymph nodes and lungs.

Tumors usually are found on 1 side, but 2-3% are found in both testicles.

Risk FactorsThe cause of testicular cancer is unknown,

but there are several known risk factors:· Family history of testicular tumors· History of an undescended testicle or a late

descending testicle· History of mumps and later shrinking of the

testicles· Injury to the scrotum· Ethnicity: More common in white than black

men

Signs and Symptoms

· Small, painless lump in a testicle· Feeling of heaviness in the testicle· Enlarging male breasts or breast tenderness· Enlargement of the testicle· A new collection of fluid or blood in the

scrotum around the testicle· Pain in the testicle

WARNING SIGNS OF CANCER 

C- hange in bowel or bladder habits.A- Sore that does not heal.U- nusual bleeding or discharge.T- hickening of lump in the testicle or elsewhere.I- ndigestion or difficulty swallowing.O- bvious change in a wart or mole.N- agging cough or hoarseness.S- udden unexplained weight loss.

If a suspicious lump exists, the physician may order tests to assist in making the diagnosis.Ultrasound· Testicular ultrasound is an excellent way to

evaluate lumps in the testicle. With ultrasound, the technician moves a wand over the area. Sound waves echo to form an image on a computer screen. This procedure is noninvasive and painless.

· In addition, when a collection of fluid or blood exists around the testicle, it may be difficult to feel a mass or lump. Ultrasound can overcome this barrier and give an accurate image of the testicle.

Blood tests· Blood tests for serum markers are often

elevated in testicular cancer.· These markers include alpha-feto-protein

(AFP) and human chorionic gonadotropin (HCG).

TSEIs a technique to examine the testes by self

for detecting abnormalities like testicular cancer.

Procedure1. Identify the patient and review personal

history, medication and family health history.

Identifies risk factors and previous baseline data.

2. Explain the procedure to patient, provide privacy and ask the patient to disrobe completely and to put on a gown.

Obtains patient’s cooperation and provide easy access while maintaining maximum privacy.

3. Wash hands and apply clean gloves. Practices clean technique.4. Instruct the patient to stand and fold up his

gown to expose genitalia. provides best exposure for examination.

5. Advise the patient to use both hands to palpate the testes. The normal testicle is smooth and uniform in consistency. Note the size, lie, shape, consistency and tenderness. The length of a normal testes should be greater than 4cm and the volume greater than 20 ml.

The left testicle normally sits slightly lower than the right testicle. The testicles are rubbery and approximately equal in size.

Pressure on testes normally produces a deep visceral pain. Twisting or torsion of the testes causes venous obstruction, edema and eventually arterial obstruction.

6. Advise the patient to palpate each testis one at a time and feel for any evidence of a small, pea size lump or abnormality.

7. Teach the patient to locate and palpate the spermatic cord and vasdeferens between the thumb and fingers (from epididymis to the inguinal ring).

Note any nodules or swelling.8. Explain that it is normal to find that one testis is

larger than the other.9. Assist the patient to a comfortable position.

Review the steps and ask the patient to redemonstrate testicular self-examination.

To provide more comfort for patient. Evaluate success of the teaching given.

10. Remove gloves and wash hands. Reduces risk of transmission of

microorganism.11. Give the patient written materials if

available. Reinforces teaching. Provides a readily

available form to patient for reference when at home.

12. Record date, time, findings of palpation and patient’s response to findings and teaching.

Special considerationsAdvise patient to perform testicular self

examination on one particular day each of month.

It is advisable to perform testicular self-examination after a warm relaxing shower.