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Testicular Health

Testicles produce male sex hormones and sperm cells. To help maintain their health, men should become familiar with the look feel and shape of their testicles. Knowing what's normal for you can help you become aware of abnormalities.

Anatomy

The testicles are generally paired, small, smooth, oval-shaped glands located in the scrotum, a sac of skin below the penis. Sperm production is affected by body temperature; the somewhat elastic skin of the scrotum allows the testicles to move closer to or further from the body to maintain optimum temperature. Attached to the back of each testicle is the epididymis, a series of small tubes that collect and store sperm. The epididymis connects to a larger tube called the vas deferens, which bring the sperm to the urethra.

Healthy testicles

Healthy testicles feel smooth and oval-shaped. They may vary from each other, but the size, shape and feel of each individual testicle should be consistent. One testicle (typically the left) may hang lower than the other. Testicles generally don’t hurt; there should be no discomfort when handling them gently. However, an occasional slight ache is typically not cause for alarm.

Pain

Sometimes, pain in one or both of your testicles just happens. Other causes include:

  • sexual arousal without ejaculation (sometimes referred to as 'blue balls');
  • muscle tension. Try a warm bath;
  • minor injury such as bumping, or wearing pants that are too tight;
  • being hit, during sports, physical activities or by accident; and
  • infection, often with burning during urination or pain in the epididymis. See your doctor if you suspect an infection.

Concerns and conditions

Non-cancerous conditions affecting the testicles include:

  • Testicular torsion: An extremely painful condition in which the cord that attaches the testicle to the body twists, cutting off the blood supply. This is an urgent condition; see your health care provider right away.
  • Persistent pain: While occasional pain isn't unusual, see your provider about pain that continues or is accompanied by swelling.
  • Painless swelling: Any painless swelling in the testicles should be checked out by a medical provider.
  • Cysts: An abnormal, yet harmless, accumulation of fluid.
  • Varicocele: Also known as varicose veins, this affects anywhere from 8 - 15% of men.
  • Hydrocele: A fluid-filled sac that surrounds a testicle, causing swelling of the scrotum. Hydroceles usually aren't painful and typically aren't harmful.
  • Epididymitis, orchitis and epididymo-orchitis: Inflammation of the epididymis, testicle or both. Treatment can include antibiotics, anti-inflammatory medications, elevation and scrotal support.
  • Blue balls: Your testicles (or 'balls') might ache if you have an erection for a long time without ejaculation, or if the penis gets soft again after an erection. This condition usually goes away in a few hours. It's not dangerous, and never a reason to pressure someone into having sex.

Testicular cancer

Testicular cancer is relatively uncommon; about 7,500 cases are diagnosed and about 400 men die of the disease each year in the United States. While it's the most common cancer impacting males between 15 - 40, it accounts for only 1% of all cancers in men. Symptoms include a painless testicular lump, a sensation of heaviness in the scrotum and a persistent ache in the lower abdomen or affected testicle. See your provider for an exam.

What to look for

Take notice of anything unusual, such as a lump or swelling in or on the testicle; changes in testicular size or shape; and changes in the testicle's consistency or feel. If youu notice a lump, swelling or hardening, a dull ache or pain, or anything else that seems unusual, don’t panic. See your health care provider if symptoms persist.

Visual exams and lab tests may also help detect some infections, including sexually transmitted ones.