Chocolate nuts

We previously reported that two chocolates—Teasers and Truffles (Celebrations, Masterfoods UK, Melton Mowbray)—were strikingly similar to the 8 ml bead of the orchidometer used to assess testicular volume.¹ We therefore suggested that they could be used to stage puberty in males and, because of their wide availability and low cost, commended their use.

We were recently dismayed to discover that the manufacturer has changed the shape of both these chocolates. Both are now flat bottomed (figure), and even non-specialists will notice that they bear little resemblance to testes. More disturbingly, they are no longer much use for assessing testicular volume. Only one of six paediatric endocrine specialists (comprising trainees, consultants, and specialist nurses) felt confident that they could use the new Teasers or Truffles to gauge testicular volume relative to the 8 ml cut-off which indicates that puberty is proceeding satisfactorily.²

How Teasers changed: Conventional 8ml orchidometer bead (centre) with 2001 Teaser (right) and 2007 teaser (left)

Dissent of the testis -- Williams and Dharmaraj 335 (7633): 1287 -- BMJ