The health of the testicles, which produce sperm and the male hormone testosterone, is a significant component of overall male wellness. Regular attention to this area is necessary for the early detection of various conditions, including infections, fluid collections, and masses. Understanding which medical professional to see and when to seek care is the first step in managing testicular health.
The Primary Care Gateway
A Primary Care Physician (PCP), such as a Family Doctor or Internal Medicine specialist, serves as the initial point of contact for routine testicular health checks. These professionals conduct a physical examination of the testicles and scrotum as part of a comprehensive annual wellness exam, looking for any unusual swelling, changes in size, or tenderness.
The PCP is equipped to diagnose and manage common, less urgent scrotal issues. These conditions often include epididymitis (inflammation of the coiled tube at the back of the testicle) or a small hydrocele (a collection of fluid around the testicle). For these conditions, the PCP can initiate treatment, such as antibiotics for an infection or monitoring a minor fluid collection. The primary care provider screens for abnormalities and determines if a referral to a specialist is necessary for further investigation or treatment.
Specialized Care The Urologist
When an issue is complex, chronic, or potentially requires surgical intervention, a Urologist is the appropriate specialist. Urologists are physicians trained specifically on the male reproductive system and the urinary tract in both men and women. Their expertise covers conditions affecting the testicles, epididymis, and vas deferens.
A Urologist provides definitive diagnosis and specialized treatment of suspicious findings, such as a solid mass suggesting testicular cancer. They manage conditions like chronic testicular pain, male infertility evaluations, and complex structural abnormalities like varicoceles (enlarged veins inside the scrotum). Urologists also perform surgical procedures, ranging from vasectomies and vasectomy reversals to correcting testicular torsion and removing cancerous testicles through an orchiectomy.
Understanding Testicular Self-Exams
Taking a proactive role in testicular health involves performing regular Testicular Self-Exams (TSEs) to become familiar with the normal feel of the testicles. The best time to perform this self-check is during or immediately after a warm bath or shower, as the heat helps the scrotal skin relax, making examination easier. It is important to examine each testicle separately using both hands.
The technique involves gently rolling the testicle between the thumb and fingers, feeling for any hard lumps, smooth rounded masses, or changes in size, shape, or consistency. It is normal for one testicle to be slightly larger or hang lower than the other, and the soft, tubular structure called the epididymis can be felt along the back. Noticing any new or unusual changes, such as a painless mass or a feeling of heaviness, should prompt a visit to a doctor for evaluation.
When to See a Doctor Immediately
Certain symptoms related to the testicles signal a medical emergency and require immediate attention at an emergency room or urgent care facility. The most time-critical condition is testicular torsion, which occurs when the spermatic cord twists, cutting off blood flow. Lack of blood supply can lead to permanent damage or loss of the testicle if not treated within hours.
Symptoms that demand immediate care include the sudden onset of severe testicular pain, especially if accompanied by nausea, vomiting, or abdominal pain. Rapid swelling of the scrotum, a testicle positioned higher than normal, or pain lasting longer than an hour are warning signs of a serious problem. Any significant trauma or injury resulting in severe pain or bruising should also be evaluated promptly to prevent long-term complications.