Ultrasound Evaluation of Scrotal Pathology

Department of Radiology, Nassau University Medical Center, East Meadow, NY 11554, USA.
Radiologic Clinics of North America (Impact Factor: 1.98). 03/2012; 50(2):317-32, vi. DOI: 10.1016/j.rcl.2012.02.005
Source: PubMed


Palpable scrotal mass, acute scrotal pain, and enlarged scrotum are common scenarios in clinical practice. The imaging modality of choice to evaluate scrotal pathology is ultrasound (US). US is key in determining if a palpable abnormality is extratesticular or intratesticular and cystic or solid. US findings help narrow the differential to benign or malignant causes. Extratesticular lesions are more common and usually benign. Rarely, extratesticular solid lesions are malignant but US features are nonspecific. Accurately diagnosing rare benign intratesticular lesions is vital to avoid unnecessary orchiectomy. This article reviews extratesticular and intratesticular lesions presenting as a palpable mass and other conditions commonly seen.

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    • "In clinical practice, the TV can be evaluated by physical examination using the Prader's orchidometer, but with a greater precision by testicular ultrasound which overcomes confounding factors such as scrotal effusions, varicose veins, intrascrotal masses, testicular pain, and distinction from adjacent anatomical structures [2]. It is well known that a significant TV decrease is associated with a worst testicular performance of both endocrine (androgen decline) and reproductive activities (abnormal sperm parameters) [3] [4] [5] [6]. "
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    ABSTRACT: Background. Reduced testicular volume (TV) (<12 cm(3)) is associated with lower testicular function. Several studies explored the conventional sperm parameters (concentration, motility, and morphology) and the endocrine function (gonadotropins and testosterone serum concentrations) in the patients with reduction of TV. No other parameters have been examined. Aim. This study aims at evaluating some biofunctional sperm parameters by flow cytometry in the semen of men with reduced TV compared with that of subjects with normal TV. Methods. 78 patients without primary scrotal disease were submitted to ultrasound evaluation of the testis. They were divided into two groups according to testicular volume: A Group, including 40 patients with normal testicular volume (TV > 15 cm(3)) and B Group, including 38 patients with reduced testicular volume (TV ≤ 12 cm(3)). All patients underwent serum hormone concentration, conventional and biofunctional (flow cytometry) sperm parameters evaluation. Results. With regard to biofunctional sperm parameters, all values (mitochondrial membrane potential, phosphatidylserine externalization, chromatin compactness, and DNA fragmentation) were strongly negatively correlated with testicular volume (P < 0.0001). Conclusions. This study for the first time in the literature states that the biofunctional sperm parameters worsen and with near linear correlation, with decreasing testicular volume.
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