Out of curiosity, how frequent did you feel it in your testicles? I get a strange discomfort sometimes for no reason, but that happens every 2-3 months, not every week or something. It'll last for 30 minutes or an hour, and then won't come back for awhile. It's not really pain, but rather a slight discomfort, like a feeling that isn't there normally.
I'm too big a wuss to grab my balls too hard, so I've never really checked. Also, I don't really know what I'm looking for, nor do I know how obvious a lump would be if it was there.
I've self-examined myself like 5 times in my life, and I really didn't think I was doing it right, or that I had enough knowledge of that area to find any strange lumps. Yes, it's lumpy down there I guess, but those could just be normal tubes and such.
There's not much to a male genital exam; the main thing is being able to recognize what's normal and what's not. From a physician's perspecive, you have to know the anatomy and have done enough to have a good baseline of what "normal" is. From your perspective, you need to know yourself...and thus be able to identify any changes that develop (lumps, bumps, tenderness, whatever).
The male genital exam is quite straight forward:
Start with a visual inspection of the surrounding area, pubic hair, looking discoloration, ulceration, lice. This includes pusing the scrotum out of the way to inspect all the way between the legs. If you are doing this on someone else, I highly recommend brushing upwards, i.e. towards the head, while examining the pubic hair (it is typically more springy than other body hair and you don't want to go flinging things into your face by stroking downward).
Next examine the shaft of the penis, again looking for discoloration, ulceration, ?trauma, urethral openings that are out of place (i.e. hypospadias). Be sure to visualize both the dorsal and the ventral surfaces. If uncircumcised, then reduce the foreskin and inspect the glans looking for any smegma. Gently squeeze the urethral meatus by pinching from top to bottom to see if any pus/purulent exudate can be expressed.
The testicles are examined both at the same time (one hand for each) to compare symmetry. They should be more or less olive shaped and sized, generally smooth to the touch however some fine nodularity can be appreciated. The testicle is, surprisingly not nearly as sensitive as one would think. The epididymis which feels like a small knob and tube is located somewhat posteriorly directly attached to the testicle, it is exceptionally sensitive, and care must be taken when palpating. You can also examine the spermatic cord and its structures as it ascends superiorly and then laterally as it enters the inguinal canal. Occasionally the venous plexus that drains the testicle can be felt, and feels like a bag of worms.
After this is the inguinal canal examination, more commonly known as the "turn and cough" part of the exam, wherein a finger is inserted into the canal via the external ring. If you feel your pubic symphisis, the joining of your right and left pelvic bones located immediately above the penis, the spermatic cord can be felt diving into the abdomen immediately lateral to the symphisis. Taking a good amount of scrotal tissue, you can quite easily insert your finger into the canal. Then, turning and coughing you can assess if an inguinal hernia is present.
The last part of the exam is a the digital rectal exam...which is fairly self explanatory. Just remember to use a lot of lube, put the pad of your finger on the anus, have the patient relax by taking slow deep breaths. Then, while inhaling, you can apply some pressure and, I don't mean to sound glib, but the anus whill often just suck your finger in. Its an uncomfortable exam, so there is no need to make it more uncomfortable by being too forceful. Then just sweep your finger around the rectal vault 360 degrees, noting any polypoid nodules, enlarged hemorrhoids. In the male exam you can also feel anteriorly (towards the penis) and feel a small walnut sized prostate that should be the consistency of the tip of your nose. On either side you may also be able to feel the two seminal vesicles extending like two butterfly wings laterally.
Ta da. All done. I wouldn't recommend doing this whole to yourself, but I just wanted you to know what doctors are being trained to do. And like I said at the beginning, it just takes experience.
