How familiar are you with your testicles? A urologist explains what’s normal and what’s not - CNN

Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida’s College of Medicine.

A guy recently walked into my clinic with his girlfriend. He had felt something in his testicle months earlier. She found out and dragged him to see me.

I did a physical exam and confirmed what I felt with an ultrasound. The lump turned out to be a benign cyst, not cancer.

He leaned over to her and said, “See. I told you so. I’m fine.” I told him he should thank her instead as this visit could have gone very differently.

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Most testicular lumps are not cancerous, but some are. And the only way to know is to get checked. When a man waits, he delays care — often for something a physician could clear up in minutes. Or a doctor could find something that could save his life.

During my urology rotation in medical school, I checked my own testicles for the first time. I found something, freaked out and made myself an appointment. Like my recent patient, it turned out I had a benign cyst — almost certainly there my whole life. I just never knew what my “normal” felt like before that milestone moment.

That’s why I recommend that patients get in the habit of doing regular self-exams. You don’t need to obsess, and there are no formal guidelines requiring monthly checks. But getting familiar with your normal anatomy — by checking periodically while showering — helps you recognize change when it happens. The whole exam takes less than two minutes.

The more you know your baseline, the easier it is to notice when something is off.

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Testicles have 2 main functions

The testicles’ first key task is making sperm. A healthy man produces tens of millions of sperm every day. These sperm can take about three months to grow, mature and make it out into the ejaculate.

The testes’ second essential job is making male sex hormones — primarily testosterone. Specialized cells called Leydig cells produce most of the testosterone in a man’s body. Testosterone is responsible for muscle mass, bone density, libido, mood, energy — all essential to a man’s function.

It’s ideal to have two testicles, but men can function with one. A man can live a full life, including fathering children, with a single testicle.

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The testicles do not start where they end up

While a male fetus is developing in the womb, testicles originate in the abdomen near the kidneys. In the final months of pregnancy, the testicles descend through a passage called the inguinal canal to land in the scrotum, the pouch that protects them for the rest of a man’s life.

That descent is the reason testicles hang outside the body and why testicular pain can radiate up the abdomen. Sperm production works best at a temperature slightly cooler than core body temperature.

The scrotum is a temperature-controlled chamber that adjusts itself — pulling the testicles closer to the body when it’s cold and lowering them when it’s warm. That’s why everything looks different in a cold pool versus a hot shower.

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What’s actually down there

The scrotum usually contains two testicles. Each one is an oval organ, smooth and firm, roughly the size of a small egg. Inside, the testicle is full of small, packed tubules called seminiferous tubules, where sperm is produced.

Attached to the back of each testicle is a soft, wormlike structure called the epididymis, where sperm mature. From there, sperm travel up through the vas deferens, a long tube that runs out of the scrotum into the lower pelvis to enter the ejaculatory ducts. This vas is the same tube that gets cut during a vasectomy.

Everything that keeps the testicle alive and functional runs through the spermatic cord — arteries, veins, nerves and lymphatics, bundled together along with the vas deferens. You can feel the structures of the cord rising from the top of each testicle. The cord is surrounded by muscle that helps the testicle move.

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