Systematic review of the literature on the role of testicular palpation during primary care consultations in the early detection of benign and malignant conditions affecting male endocrine and reproductive health : Systematic Review Protocol

This protocol describes a systematic review of clinician-performed testicular examination in primary care for males aged 12 years and older. Target presentations include scrotal symptoms, an initial infertility work-up, risk factors such as prior cryptorchidism, or general concern. We will search MEDLINE/PubMed, Embase and Cochrane CENTRAL. The last search will be on 15 Oct 2025. We will include studies in English or French from 2010 to 2025. Eligible designs are RCTs if any, quasi-experimental studies, cohort, case–control, cross-sectional and diagnostic-accuracy studies in first-line settings. Screening will be done in Rayyan by two reviewers working independently and blinded. Risk of bias will be assessed with RoB 2, ROBINS-I, QUADAS-2 and JBI tools. We will use a structured narrative synthesis following PRISMA 2020 and SWiM. No meta-analysis or HSROC is planned. Key outcomes are clinically useful detection, harms and safety, acceptability, and diagnostic performance at the study level. We will report sensitivity and specificity and PPV/NPV when they can be calculated. Certainty will be judged with GRADE and with GRADE-DTA for diagnostic accuracy. Any changes to the protocol will be logged. Registration in PROSPERO is planned and the DOI will be added once available.