Testicular Self Examination (TSE) and non-cancerous conditions

TSE can identify testicular problems including cancer. It can be performed in a bath or shower when the scrotum is warm and relaxed. Each testicle should be checked separately using both hands (see diagram below). The thumb and fingers can be used to feel the surface of each testicle for any lumps. The epididymis or sperm collecting tube can be felt behind each testicle and will feel soft and spongy.

It is important to understand that most abnormalities men may find when performing TSE will not be testicular cancer. There are non-cancerous conditions which are more common (see below), and can affect different parts of the testicles. Any abnormality needs to be checked by a doctor but most abnormalities will not be cancer. A small painless lump within the body of the testicle itself, is more suspicious.

Non-cancerous Conditions


Epididymo-orchitis is common in young men aged 15-30. It is a condition where either the epididymis or testis, or both, become inflamed. This is usually caused by infection, either a urinary infection or a sexually transmitted disease (STD). Swelling tends to occur quickly and is painful. It may take several weeks to fully settle. A course of strong antibiotics will usually be prescribed to treat it.


Varicoceles may can affect men of all ages. It is not known exactly what causes a varicocele but the veins in the scrotum becoming dilated, like varicose veins in the legs. Varicoceles can vary in size and are usually not painful but may cause a “dragging” sensation. It is rare for varicoceles to require treatment.


A lubricating fluid within a sac inside the scrotum allows the testicles to move freely. Sometimes clear fluid may accumulate within the sac surrounding the testicle and is called a hydrocele. A hydrocele will often feel like a small fluid-filled balloon and unless large rarely give rise to symptoms. Hydroceles can be surgically repaired or drained if they become uncomfortable or too big. If a hydrocele develops very quickly medical advice should be considered to ensure there is no abnormality of the testicle which may have caused this.

Epididymal Cysts

Epididymal cysts usually develop in adults and may take many years to form. These are quite common and are small, fluid filled sacs often about the size of a pea although can be larger.  They are smooth and round and found at the head of the epididymis, not in the testicles. Epididymal cysts which contain clear fluid or sperm are not cancerous and generally do not require treatment. Surgical removal may be considered if these become large or cause significant pain.   

Reviewed 1/2024

Images courtesy of European Association of Urology.