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What is scrotal ultrasound? 

Scrotal ultrasound is an imaging test to look for abnormalities in the scrotum. Scrotum is the fleshy sac that hangs under the penis. It holds testicles, the most important organs of the male reproductive system. Testicles produce sperms and testosterone, the male sex hormone. 

Ultrasound produces images of different organs of the body with the help of high-frequency sound waves. It involves the use of a transducer, a small handheld device that emits sound waves. These waves bounce off body tissues and are received again (echoes) by the transducer, which are then processed and displayed as images on a computer screen. Any abnormality shows a different echo and a slightly different image than the normal one, which can be interpreted by the doctor. 

The alternative names of the test are testicular sonogram and testicular ultrasound.

  1. Why is a scrotal ultrasound done?
  2. Who cannot have a scrotal ultrasound?
  3. How should I prepare for a scrotal ultrasound?
  4. What is the procedure for a scrotal ultrasound?
  5. How will a scrotal ultrasound feel?
  6. What do the results of a scrotal ultrasound mean?
  7. What are the risks and benefits of a scrotal ultrasound?
  8. What happens after a scrotal ultrasound?
  9. What are the other tests that can be done with a scrotal ultrasound?

This test helps in diagnosing the disorders of the testicles, scrotum, epididymis, which is the tube that collects and transport the sperm produced by the testicles. 

Your doctor may ask for a scrotal ultrasound in the following conditions:

  • To diagnose conditions caused due to trauma to the scrotum
  • To evaluate the cause of infertility such as blockage to the flow of semen 
  • To determine the location of undescended testis 
  • To diagnose causes of testicular pain or swelling such as inflammation or torsion. Testicular torsion is a condition in which the spermatic cord (a cord that supplies blood to the testicles) gets twisted. This test can also help find the cause of testicular torsion
  • Testicular tumours: A scrotal ultrasound can be used to check if you have a solid lump in your scrotum, indicating a tumour or if you have a fluid-filled cyst in your scrotum. 
  • Varicoceles 

Furthermore, this test along with Doppler aids in examining the flow of blood in the direction to and away from your testicles. 

There are no contraindications for a scrotal ultrasound.

You do not need any special preparation before this test. Make sure you wear loose clothes when going for the scan. You may be instructed to wear a hospital gown before the test and will have to remove all your clothes in the area that is to be tested. 

In case your son is having the test, you may be allowed to accompany him for support. You can explain to him how the test is going to be performed.

You will not need to fast or have a full bladder before the test. Although medications rarely need to be discontinued before this test, inform your doctor if you are taking any medicines

You will be asked to lie down on your back and spread your legs. A technician will position a towel under your scrotum to keep it elevated. Do not move while the scanning is being performed. The technician will follow the procedure as mentioned below:

  • They will apply a warm gel on your testicles; this helps the sound waves to pass through the skin.
  • They will then move the transducer on the area to be examined in different angles. You may feel some discomfort if the region is tender due to some abnormality. 
  • Once the procedure is over, the technician will wipe the gel off.

The entire test takes 15 to 30 minutes usually, but sometimes, it may take a bit longer.

It is a painless procedure. The gel may feel slightly cold.

In a normal scrotal ultrasound, the testicles and other regions of the scrotum appear normal. Abnormal findings in the results can be an indication of the following conditions:

  • Benign cyst
  • Infection in your testicle
  • Testicular torsion
  • Testicular tumour
  • Varicocele
  • Hydrocele
  • Spermatocele - a fluid-filled cyst on the ducts of your testicle

Scrotal ultrasound has the following benefits:

  • Non-invasive
  • Widely available and easy-to-use
  • May cause temporary discomfort but is painless
  • Extremely safe
  • No use of radiation
  • More preferable over X-rays for soft tissues

This procedure has no known risks to humans.

Since a scrotal ultrasound is non-invasive, you don’t need any recovery time. After the ultrasound, you may go back to your everyday work and continue with your usual diet. 

A Doppler ultrasound may help in identifying the blood flow in your scrotum, and testicles which can help in determining testicular torsion as blood flow is reduced in cases of twisted testicles.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. UFHealth [internet]. University of Florida; Scrotal ultrasound. Gainesville. Florida. US; Scrotal ultrasound
  2. US Food and Drug Administration (FDA) [internet]. Maryland. US; Ultrasound Imaging
  3. MYCourses: Harvard medical school [Internet]. Harvard University. Cambridge. Massachusetts. USA; Ultrasound (US)
  4. Radiological Society of North America (RSNA) [internet]. Oak Brook. Illinois. USA; Ultrasound - Scrotum
  5. Shaida N, Berman L. Male genitourinary tract. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2015:chap 40.
  6. Gilbert BR, Fulgham PF. Urinary tract imaging: basic principles of urologic ultrasonography. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 3.
  7. Sommers D, Winter T. The scrotum. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 22.
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