Ultrasound is the first line imaging modality for the evaluation of testicular abnormalities. It is safe, painless, and reliable means of showing testicular anatomy, locating testicular masses and assessing their vascularity.
Why do I need testis ultrasound (Scrotum ultrasound)?
Scrotal pain, swelling or a palpable lump are common signs and symptoms upon clinical examinations. A testicular ultrasound is used to obtain images of the testicles and the surrounding area in the scrotum. Ultrasound can distinguish a testicular mass from an extra testicular mass as well as whether a mass is cystic, solid, or complex. It is also capable of distinguishing between a benign and malignant lesion.
What happen during my scan?
There is no particular preparation for this scan. you will be asked to bring down your trousers and underwear. The testicles and scrotum are lifted, and a paper towel is placed underneath to support the scrotum. The patient holds another paper towel to cover the penis and holds it against the abdominal wall. A high-frequency linear transducer is used to obtain images of the structures in your testis.
What is Epididymitis and epididymo-orchitis?
Acute scrotal pain is a common sign of Epididymitis affecting adolescent boys and male adults. It is usually caused by a bacterial infection such as lower urinary tract infections (UTI) and sexually transmitted disease (STD). Symptoms can include fever, dysuria and discharge. When the bacterial infection is spread to the testes, this is known as epididymo-orchitis.
Other abnormalities which can be detected by ultrasounds are :
Trauma
Testicular trauma is most encountered after injury such as a car accident or sports injury. Ultrasound evaluation of an injured testicle is critical in deciding whether prompt surgical intervention is required. Fluid collections (hydrocele, haematocele or hematoma), testicular rupture and vascular injury can be signs of testicular trauma.
Torsion
Testicular torsion is a condition where the testicles twist around the spermatic cord, therefore, cutting off the blood supply causing pain and swelling. It is more common in younger boys between the ages of 12 and 18. Immediate diagnoses is required, as delaying it can cause the loss of testes.
Varicocele
Varicoceles is the most frequent palpable mass. They develop when blood flow from the spermatic cord is impaired, producing abnormal dilatation of the pampiniform plexus veins. The pampiniform plexus veins usually measure 0.5 to 1.5 mm in diameter and veins that are greater than 3mm are considered to be abnormal. Cases of Idiopathic varicocele is caused by impaired draining of blood. Secondary varicocele occurs due to an increase of pressure in the testicular vein which is caused by various conditions such as hydronephrosis, obstruction from a pelvic or abdominal mass or obstruction such as renal vein thrombus.
Hydrocele
Hydrocele is the significant accumulation of fluid within the thin sheath that surrounds the testicles. It is the most common cause of painless scrotal swelling. Hydroceles can be congenital or acquired. Acquired hydrocele could be idiopathic due to overproduction or because of impaired fluid absorption. Hydroceles can also be caused secondary to trauma, infection, torsion, or tumour.
Microlithiasis
Microlithiasis is a condition that causes tiny clusters of calcium to develop in the testicles. Microcalcifications in the testes are uncommon and usually discovered incidentally. it is asymptomatic and does not cause any pain. Microlithiasis has been shown to be associated with testicular neoplasms. Patients presenting with microcalcifications are advised to undergo annual ultrasound scans, particularly if they are symptomatic.
Testicular cysts
Simple testicular cysts are a common incidental finding. Their cause is usually unkown. However, they may appear as a result of previous inflammation or trauma. An epididymal cyst is found in the epididymis. These cysts are clinically insignificant unless they are symptomatic, and no treatment is required. An epidermoid cyst is the most common benign testicular mass. They can present as a mass or usually an incidental finding on sonographic examination.
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