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Scrotal Ultrasound

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Ultrasound of the Male Genitalia

Abstract

Portability, safety, low cost and efficiency, together with the ability to accurately define pathology rapidly, have made ultrasound the primary imaging modality for evaluation of the scrotum, testis and paratesticular structures. These factors provide for timely diagnosis and treatment. Scrotal ultrasound is particularly helpful when a physical examination is inconclusive or a disease process prevents adequate examination. The detailed imaging of ultrasonography is often an essential component of the diagnosis of a variety of symptoms including scrotal pain or trauma, infertility and abnormal findings on physical exam. This chapter will explore the techniques and protocols for performing scrotal ultrasounds in order to make the most thorough assessment of patient symptoms leading to diagnosis.

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References

  1. AIUM practice guideline for the performance of an ultrasound examination in the practice of urology. J Ultrasound Med. 2012;31(1):133–44.

    Google Scholar 

  2. Nielsen ME. Use and misuse of imaging by urologists. J Urol. 2010;184(1):12–4.

    PubMed  Google Scholar 

  3. Douglas PS. Improving imaging: our professional imperative. J Am Coll Cardiol. 2006;48(10):2152–5.

    PubMed  Google Scholar 

  4. Dogra V, Bhatt S. Acute painful scrotum. Radiol Clin North Am. 2004;42(2):349–63.

    PubMed  Google Scholar 

  5. Smart JM, et al. Ultrasound findings of masses of the paratesticular space. Clin Radiol. 2008;63(8):929–38.

    CAS  PubMed  Google Scholar 

  6. Hadziselimovic F, et al. The importance of mini-puberty for fertility in cryptorchidism. J Urol. 2005;174(4 Pt 2):1536–9; discussion 1538–9.

    PubMed  Google Scholar 

  7. Raivio T, et al. Serum androgen bioactivity in cryptorchid and noncryptorchid boys during the postnatal reproductive hormone surge. J Clin Endocrinol Metab. 2003;88(6):2597–9.

    CAS  PubMed  Google Scholar 

  8. Kuijper EA, et al. Ultrasonographically measured testicular volumes in 0- to 6-year-old boys. Hum Reprod. 2008;23(4):792–6.

    CAS  PubMed  Google Scholar 

  9. Aso C, et al. Gray-scale and color Doppler sonography of scrotal disorders in children: an update. Radiographics. 2005;25(5):1197–214.

    PubMed  Google Scholar 

  10. Wein AJ, Kavoussi LR, Campbell MF. In: Wein AJ, Kavoussi LR, et al. Campbell-Walsh urology. 10th ed. Philadelphia: Elsevier Saunders; 2012.

    Google Scholar 

  11. Dogra VS, et al. Sonography of the scrotum. Radiology. 2003;227(1):18–36.

    PubMed  Google Scholar 

  12. Thomas RD, Dewbury KC. Ultrasound appearances of the rete testis. Clin Radiol. 1993;47(2):121–4.

    CAS  PubMed  Google Scholar 

  13. Pearl MS, Hill MC. Ultrasound of the scrotum. Semin Ultrasound CT MR. 2007;28(4):225–48.

    PubMed  Google Scholar 

  14. Favorito LA, Cavalcante AG, Babinski MA. Study on the incidence of testicular and epididymal appendages in patients with cryptorchidism. Int Braz J Urol. 2004;30(1):49–52.

    PubMed  Google Scholar 

  15. Bhatt S, et al. Imaging of non-neoplastic intratesticular masses. Diagn Interv Radiol. 2010;184(1):124.

    Google Scholar 

  16. Wishahi MM. Anatomy of the venous drainage of the human testis: testicular vein cast, microdissection and radiographic demonstration. A new anatomical concept. Eur Urol. 1991;20(2):154–60.

    CAS  PubMed  Google Scholar 

  17. Black JA, Patel A. Sonography of the normal extratesticular space. AJR Am J Roentgenol. 1996;167(2):503–6.

    CAS  PubMed  Google Scholar 

  18. Metcalfe PD, et al. Pediatric testicular tumors: contemporary incidence and efficacy of testicular preserving surgery. J Urol. 2003;170(6 Pt 1):2412–5; discussion 2415–6.

    PubMed  Google Scholar 

  19. Horwich A, Shipley J, Huddart R. Testicular germ-cell cancer. Lancet. 2006;367(9512):754–65.

    CAS  PubMed  Google Scholar 

  20. Schwerk WB, Schwerk WN, Rodeck G. Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. Radiology. 1987;164(2):369–74.

    CAS  PubMed  Google Scholar 

  21. Woodward PJ, et al. From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22(1):189–216.

    PubMed  Google Scholar 

  22. Shah A, et al. Re: new ultrasound techniques for imaging of the indeterminate testicular lesion may avoid surgery completely. Clin Radiol. 2010;65(6):496–7.

    CAS  PubMed  Google Scholar 

  23. Frush DP, Sheldon CA. Diagnostic imaging for pediatric scrotal disorders. Radiographics. 1998;18(4):969–85.

    CAS  PubMed  Google Scholar 

  24. Mirochnik B, et al. Ultrasound evaluation of scrotal pathology. Radiol Clin North Am. 2012;50(2):317–32, vi.

    PubMed  Google Scholar 

  25. Khalid M, et al. Concomitant bilateral testicular epidermoid cysts. Saudi Med J. 2008;29(6):907–9.

    PubMed  Google Scholar 

  26. Dogra VS, et al. Testicular epidermoid cysts: sonographic features with histopathologic correlation. J Clin Ultrasound. 2001;29(3):192–6.

    CAS  PubMed  Google Scholar 

  27. Malvica RP. Epidermoid cyst of the testicle: an unusual sonographic finding. AJR Am J Roentgenol. 1993;160(5):1047–8.

    CAS  PubMed  Google Scholar 

  28. Loya AG, Said JW, Grant EG. Epidermoid cyst of the testis: radiologic-pathologic correlation. Radiographics. 2004;24(Suppl 1):S243–6.

    PubMed  Google Scholar 

  29. Aganovic L, Cassidy F. Imaging of the scrotum. Radiol Clin North Am. 2012;50(6):1145–65.

    PubMed  Google Scholar 

  30. Hasselblom S, et al. Testicular lymphoma–a retrospective, population-based, clinical and immunohistochemical study. Acta Oncol. 2004;43(8):758–65.

    PubMed  Google Scholar 

  31. Vural F, et al. Primary testicular lymphoma. J Natl Med Assoc. 2007;99(11):1277–82.

    PubMed Central  PubMed  Google Scholar 

  32. Zucca E, et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol. 2003;21(1):20–7.

    CAS  PubMed  Google Scholar 

  33. Garcia-Gonzalez R, Pinto J, Val-Bernal JF. Testicular metastases from solid tumors: an autopsy study. Ann Diagn Pathol. 2000;4(2):59–64.

    CAS  PubMed  Google Scholar 

  34. Tiltman AJ. Metastatic tumours in the testis. Histopathology. 1979;3(1):31–7.

    CAS  PubMed  Google Scholar 

  35. Angulo JC, et al. Clinicopathological study of regressed testicular tumors (apparent extragonadal germ cell neoplasms). J Urol. 2009;182(5):2303–10.

    PubMed  Google Scholar 

  36. Carmignani L, et al. High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol. 2003;170(5):1783–6.

    PubMed  Google Scholar 

  37. Muller T, et al. Management of incidental impalpable intratesticular masses of < or = 5 mm in diameter. BJU Int. 2006;98(5):1001–4.

    PubMed  Google Scholar 

  38. Hallak J, et al. Organ-sparing microsurgical resection of incidental testicular tumors plus microdissection for sperm extraction and cryopreservation in azoospermic patients: surgical aspects and technical refinements. Urology. 2009;73(4):887–91; discussion 891–2.

    Google Scholar 

  39. Toren PJ, et al. Small incidentally discovered testicular masses in infertile men—is active surveillance the new standard of care? J Urol. 2010;183(4):1373–7.

    PubMed  Google Scholar 

  40. Goddi A, et al. Real-time tissue elastography for testicular lesion assessment. Eur Radiol. 2012;22(4):721–30.

    PubMed Central  PubMed  Google Scholar 

  41. Aigner F, et al. Real-time sonoelastography for the evaluation of testicular lesions. Radiology. 2012;263(2):584–9.

    PubMed  Google Scholar 

  42. Ringdahl E, Teague L. Testicular torsion. Am Fam Physician. 2006;74(10):1739–43.

    PubMed  Google Scholar 

  43. Bartsch G, et al. Testicular torsion: late results with special regard to fertility and endocrine function. J Urol. 1980;124(3):375–8.

    CAS  PubMed  Google Scholar 

  44. Waldert M, et al. Color Doppler sonography reliably identifies testicular torsion in boys. Urology. 2010;75(5):1170–4.

    PubMed  Google Scholar 

  45. Jee WH, et al. Resistive index of the intrascrotal artery in scrotal inflammatory disease. Acta Radiol. 1997;38(6):1026–30.

    CAS  PubMed  Google Scholar 

  46. Yagil Y, et al. Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 2010;29(1):11–21.

    PubMed  Google Scholar 

  47. Dogra VS, et al. Benign intratesticular cystic lesions: US features. Radiographics. 2001;21(Spec No):S 273–81.

    Google Scholar 

  48. Nakagawa A, et al. In vivo analysis of phagocytosis of apoptotic cells by testicular sertoli cells. Mol Reprod Dev. 2005;71(2):166–77.

    CAS  PubMed  Google Scholar 

  49. Drut R, Drut RM. Testicular microlithiasis: histologic and immunohistochemical findings in 11 pediatric cases. Pediatr Dev Pathol. 2002;5(6):544–50.

    PubMed  Google Scholar 

  50. van Casteren NJ, Looijenga LH, Dohle GR. Testicular microlithiasis and carcinoma in situ overview and proposed clinical guideline. Int J Androl. 2009;32(4):279–87.

    CAS  PubMed  Google Scholar 

  51. Dagash H, Mackinnon EA. Testicular microlithiasis: what does it mean clinically? BJU Int. 2007;99(1):157–60.

    PubMed  Google Scholar 

  52. Middleton WD, Teefey SA, Santillan CS. Testicular microlithiasis: prospective analysis of prevalence and associated tumor. Radiology. 2002;224(2):425–8.

    PubMed  Google Scholar 

  53. Goede J, et al. Prevalence of testicular microlithiasis in asymptomatic males 0 to 19 years old. J Urol. 2009;182(4):1516–20.

    CAS  PubMed  Google Scholar 

  54. Kocaoglu M, et al. Testicular microlithiasis in pediatric age group: ultrasonography findings and literature review. Diagn Interv Radiol. 2005;11(1):60–5.

    PubMed  Google Scholar 

  55. von Eckardstein S, et al. Sonographic testicular microlithiasis as an indicator of premalignant conditions in normal and infertile men. J Androl. 2001;22(5):818–24.

    Google Scholar 

  56. Furness PD, 3rd, et al. Multi-institutional study of testicular microlithiasis in childhood: a benign or premalignant condition? J Urol. 1998;160(3 Pt 2):1151–4; discussion 1178.

    PubMed  Google Scholar 

  57. DeCastro BJ, Peterson AC, Costabile RA. A 5-year followup study of asymptomatic men with testicular microlithiasis. J Urol. 2008;179(4):1420–3; discussion 1423.

    PubMed  Google Scholar 

  58. Frush DP, Kliewer MA, Madden JF. Testicular microlithiasis and subsequent development of metastatic germ cell tumor. AJR Am J Roentgenol. 1996;167(4):889–90.

    CAS  PubMed  Google Scholar 

  59. Dieckmann KP, Skakkebaek NE. Carcinoma in situ of the testis: review of biological and clinical features. Int J Cancer. 1999;83(6):815–22.

    CAS  PubMed  Google Scholar 

  60. Comiter CV, et al. Burned-out primary testicular cancer: sonographic and pathological characteristics. J Urol. 1996;156(1):85–8.

    CAS  PubMed  Google Scholar 

  61. Gooding GA, Leonhardt W, Stein R. Testicular cysts: US findings. Radiology. 1987;163(2):537–8.

    CAS  PubMed  Google Scholar 

  62. Carver BS, Al-Ahmadie H, Sheinfeld J. Adult and pediatric testicular teratoma. Urol Clin North Am. 2007;34(2):245–51; abstract x.

    PubMed  Google Scholar 

  63. Chou SJ, et al. Cysts of the tunica albuginea. Arch Androl. 2004;50(2):89–92.

    PubMed  Google Scholar 

  64. Tammela TL, et al. Cysts of the tunica albuginea—more common testicular masses than previously thought? Br J Urol. 1991;68(3):280–4.

    CAS  PubMed  Google Scholar 

  65. Nistal M, Mate A, Paniagua R. Cystic transformation of the rete testis. Am J Surg Pathol. 1996;20(10):1231–9.

    CAS  PubMed  Google Scholar 

  66. Nair R, et al. Tubular ectasia of the rete testis: a diagnostic dilemma. Ann R Coll Surg Engl. 2008;90(7):W1–3.

    PubMed Central  PubMed  Google Scholar 

  67. Bree RL, Hoang DT. Scrotal ultrasound. Radiol Clin North Am. 1996;34(6):1183–205.

    CAS  PubMed  Google Scholar 

  68. Atasoy C, Fitoz S. Gray-scale and color Doppler sonographic findings in intratesticular varicocele. J Clin Ultrasound. 2001;29(7):369–73.

    CAS  PubMed  Google Scholar 

  69. Bucci S, et al. Intratesticular varicocele: evaluation using grey scale and color Doppler ultrasound. World J Urol. 2008;26(1):87–9.

    PubMed  Google Scholar 

  70. Kessler A, et al. Intratesticular varicocele: gray scale and color Doppler sonographic appearance. J Ultrasound Med. 2005;24(12):1711–6.

    PubMed  Google Scholar 

  71. Das KM, et al. Intratesticular varicocele: evaluation using conventional and Doppler sonography. AJR Am J Roentgenol. 1999;173(4):1079–83.

    CAS  PubMed  Google Scholar 

  72. Mouritsen A, et al. Testicular adrenal rest tumours in boys, adolescents and adult men with congenital adrenal hyperplasia may be associated with the CYP21A2 mutation. Int J Androl. 2010;33(3):521–7.

    CAS  PubMed  Google Scholar 

  73. Claahsen-van der Grinten HL, et al. Prevalence of testicular adrenal rest tumours in male children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Eur J Endocrinol. 2007;157(3):339–44.

    CAS  PubMed  Google Scholar 

  74. Dogra V, Nathan J, Bhatt S. Sonographic appearance of testicular adrenal rest tissue in congenital adrenal hyperplasia. J Ultrasound Med. 2004;23(7):979–81.

    PubMed  Google Scholar 

  75. Proto G, et al. Bilateral testicular adrenal rest tissue in congenital adrenal hyperplasia: US and MR features. J Endocrinol Invest. 2001;24(7):529–31.

    CAS  PubMed  Google Scholar 

  76. Dieckmann KP, et al. Bilateral testicular germ cell tumors. Report of nine cases and review of the literature. Cancer. 1986;57(6):1254–8.

    CAS  PubMed  Google Scholar 

  77. Datta SN, et al. A case of scrotal sarcoidosis that mimicked tuberculosis. Nat Clin Pract Urol. 2007;4(4):227–30.

    PubMed  Google Scholar 

  78. Deurdulian C, et al. US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics. 2007;27(2):357–69.

    PubMed  Google Scholar 

  79. Cubillos J, et al. A conservative approach to testicular rupture in adolescent boys. J Urol. 2010;184(4 Suppl):1733–8.

    PubMed  Google Scholar 

  80. Wittenberg AF, et al. Sonography of the acute scrotum: the four T’s of testicular imaging. Curr Probl Diagn Radiol. 2006;35(1):12–21.

    PubMed  Google Scholar 

  81. Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 2006;175(1):175–8.

    PubMed  Google Scholar 

  82. Guichard G, et al. Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology. 2008;71(1):52–6.

    PubMed  Google Scholar 

  83. Kim SH, et al. The efficacy of magnetic resonance imaging for the diagnosis of testicular rupture: a prospective preliminary study. J Trauma. 2009;66(1):239–42.

    PubMed  Google Scholar 

  84. Bhatt S, Dogra VS. Role of US in testicular and scrotal trauma. Radiographics. 2008;28(6):1617–29.

    PubMed  Google Scholar 

  85. Garriga V, et al. US of the tunica vaginalis testis: anatomic relationships and pathologic conditions. Radiographics. 2009;29(7):2017–32.

    PubMed  Google Scholar 

  86. Chandra RV, et al. Rational approach to diagnosis and management of blunt scrotal trauma. Urology. 2007;70(2):230–4.

    PubMed  Google Scholar 

  87. Osifo OD, Osaigbovo EO. Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria. J Pediatr Urol. 2008;4(3):178–82.

    CAS  PubMed  Google Scholar 

  88. Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37(3):613–26, x.

    PubMed  Google Scholar 

  89. Mihmanli I, et al. Testicular size and vascular resistance before and after hydrocelectomy. AJR Am J Roentgenol. 2004;183(5):1379–85.

    PubMed  Google Scholar 

  90. Jones ME, et al. Risk of congenital inguinal hernia in siblings: a record linkage study. Paediatr Perinat Epidemiol. 1998;12(3):288–96.

    CAS  PubMed  Google Scholar 

  91. Rescorla FJ, et al. The “other side” of pediatric hernias: the role of laparoscopy. Am Surg. 1997;63(8):690–3.

    CAS  PubMed  Google Scholar 

  92. Erez I, et al. Preoperative ultrasound and intraoperative findings of inguinal hernias in children: a prospective study of 642 children. J Pediatr Surg. 2002;37(6):865–8.

    PubMed  Google Scholar 

  93. Adams CE, Wald M. Risks and complications of vasectomy. Urol Clin North Am. 2009;36(3):331–6.

    PubMed  Google Scholar 

  94. Greek G. Vasectomy. A safe, effective, economical means of sterilization. Postgrad Med. 2000;108(2):173–6, 179.

    Google Scholar 

  95. Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertil Steril. 2000;73(5):923–36.

    CAS  PubMed  Google Scholar 

  96. Somekh E, Gorenstein A, Serour F. Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol. 2004;171(1):391–4; discussion 394.

    PubMed  Google Scholar 

  97. Bohm MK, Gift TL, Tao G. Patterns of single and multiple claims of epididymitis among young privately-insured males in the United States, 2001 to 2004. Sex Transm Dis. 2009;36(8):490–2.

    PubMed  Google Scholar 

  98. Akba SA, et al. Multimodality imaging of paratesticular neoplasms and their rare mimics. Radiographics. 2003;23(6):1461–76.

    Google Scholar 

  99. Aydin H, et al. Clear cell papillary cystadenoma of the epididymis and mesosalpinx: immunohistochemical differentiation from metastatic clear cell renal cell carcinoma. Am J Surg Pathol. 2005;29(4):520–3.

    PubMed  Google Scholar 

  100. Alexander JA, Lichtman JB, Varma VA. Ultrasound demonstration of a papillary cystadenoma of the epididymis. J Clin Ultrasound. 1991;19(7):442–5.

    CAS  PubMed  Google Scholar 

  101. Tchelepi H, et al. Sonography of spermatic cord leiomyoma: case report and review of the literature. J Ultrasound Med. 2004;23(4):569–71.

    PubMed  Google Scholar 

  102. Salm R. Papillary sarcinoma of the epididymis. J Pathol. 1969;97(2):253–9.

    CAS  PubMed  Google Scholar 

  103. Dowling KJ, Lieb HE. Fibrosarcoma of epididymis. Urology. 1985;26(3):307–8.

    CAS  PubMed  Google Scholar 

  104. Kurihara K, et al. Papillary adenocarcinoma of the epididymis. Acta Pathol Jpn. 1993;43(7–8):440–3.

    CAS  PubMed  Google Scholar 

  105. Malik AM, et al. The spectrum of presentation and management of Fournier’s gangrene–an experience of 73 cases. J Pak Med Assoc. 2010;60(8):617–9.

    PubMed  Google Scholar 

  106. Sorensen MD, et al. Fournier’s gangrene: management and mortality predictors in a population based study. J Urol. 2009;182(6):2742–7.

    PubMed Central  PubMed  Google Scholar 

  107. Levenson RB, Singh AK, Novelline RA. Fournier gangrene: role of imaging. Radiographics. 2008;28(2):519–28.

    PubMed  Google Scholar 

  108. Rajan DK, Scharer KA. Radiology of Fournier’s gangrene. AJR Am J Roentgenol. 1998;170(1):163–8.

    CAS  PubMed  Google Scholar 

  109. Swygert KE, et al. Melanoma in situ involving an epidermal inclusion (infundibular) cyst. Am J Dermatopathol. 2007;29(6):564–5.

    PubMed  Google Scholar 

  110. Hara Y, et al. Acute scrotum caused by Henoch-Schonlein purpura. Int J Urol. 2004;11(7):578–80.

    PubMed  Google Scholar 

  111. Germaine P, Simerman LP. Fibrous pseudotumor of the scrotum. J Ultrasound Med. 2007;26(1):133–8.

    PubMed  Google Scholar 

  112. Seethala RR, et al. Diffuse fibrous pseudotumor of the testicular tunics associated with an inflamed hydrocele. Arch Pathol Lab Med. 2003;127(6):742–4.

    PubMed  Google Scholar 

  113. Lee A, et al. Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit. Eur Radiol. 2009;19(8):2075–80.

    PubMed  Google Scholar 

  114. Thomas AC, et al. Ultrasound findings of acute idiopathic scrotal edema. ScientificWorldJournal. 2004;4(Suppl 1):9–10.

    PubMed  Google Scholar 

  115. Grainger AJ, Hide IG, Elliott ST. The ultrasound appearances of scrotal oedema. Eur J Ultrasound. 1998;8(1):33–7.

    CAS  PubMed  Google Scholar 

  116. Sung EK, Setty BN, Castro-Aragon I. Sonography of the pediatric scrotum: emphasis on the Ts–torsion, trauma, and tumors. AJR Am J Roentgenol. 2012;198(5):996–1003.

    PubMed  Google Scholar 

  117. Lowe FC. Squamous-cell carcinoma of the scrotum. Urol Clin North Am. 1992;19(2):397–405.

    CAS  PubMed  Google Scholar 

  118. Shafik A, et al. Testicular veins: anatomy and role in varicocelogenesis and other pathologic conditions. Urology. 1990;35(2):175–82.

    CAS  PubMed  Google Scholar 

  119. Gat Y, et al. Induction of spermatogenesis in azoospermic men after internal spermatic vein embolization for the treatment of varicocele. Hum Reprod. 2005a;20(4):1013–7.

    PubMed  Google Scholar 

  120. Gat Y, et al. Varicocele, hypoxia and male infertility. Fluid Mechanics analysis of the impaired testicular venous drainage system. Hum Reprod. 2005b;20(9):2614–9.

    PubMed  Google Scholar 

  121. Wishahi MM. Anatomy of the spermatic venous plexus (pampiniform plexus) in men with and without varicocele: intraoperative venographic study. J Urol. 1992;147(5):1285–9.

    CAS  PubMed  Google Scholar 

  122. Braedel HU, et al. A possible ontogenic etiology for idiopathic left varicocele. J Urol. 1994;151(1):62–6.

    CAS  PubMed  Google Scholar 

  123. Gorenstein A, Katz S, Schiller M. Varicocele in children: “To treat or not to treat”–venographic and manometric studies. J Pediatr Surg. 1986;21(12):1046–50.

    CAS  PubMed  Google Scholar 

  124. Iafrate M, et al. Varicocele is associated with an increase of connective tissue of the pampiniform plexus vein wall. World J Urol. 2009;27(3):363–9.

    PubMed  Google Scholar 

  125. World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril. 1992;57(6):1289–93.

    Google Scholar 

  126. Benoff S, Gilbert BR. Varicocele and male infertility: part I. Preface. Hum Reprod Update. 2001;7(1):47–54.

    CAS  PubMed  Google Scholar 

  127. Robinson SP, Hampton LJ, Koo HP. Treatment strategy for the adolescent varicocele. Urol Clin North Am. 2010;37(2):269–78.

    PubMed  Google Scholar 

  128. Sakamoto H, et al. Effects of varicocele repair in adults on ultrasonographically determined testicular volume and on semen profile. Urology. 2008;71(3):485–9.

    PubMed  Google Scholar 

  129. Zucchi A, et al. Varicocele and fertility: relationship between testicular volume and seminal parameters before and after treatment. J Androl. 2006;27(4):548–51.

    PubMed  Google Scholar 

  130. Tarhan S, et al. Long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow. J Androl. 2011;32(1):33–9.

    PubMed  Google Scholar 

  131. Cornud F, et al. Varicocele: strategies in diagnosis and treatment. Eur Radiol. 1999;9(3):536–45.

    CAS  PubMed  Google Scholar 

  132. Donkol RH. Imaging in male-factor obstructive infertility. World J Radiol. 2010;2(5):172–9.

    PubMed Central  PubMed  Google Scholar 

  133. Honig SC, Lipshultz LI, Jarow J. Significant medical pathology uncovered by a comprehensive male infertility evaluation. Fertil Steril. 1994;62(5):1028–34.

    CAS  PubMed  Google Scholar 

  134. McCallum T, et al. Unilateral renal agenesis associated with congenital bilateral absence of the vas deferens: phenotypic findings and genetic considerations. Hum Reprod. 2001;6(2):282–8.

    Google Scholar 

  135. Pinggera GM, et al. Assessment of the intratesticular resistive index by colour Doppler ultrasonography measurements as a predictor of spermatogenesis. BJU Int. 2008;101(6):722–6.

    PubMed  Google Scholar 

  136. Lefort C, et al. Ischemic orchiditis: review of 5 cases diagnosed by color Doppler ultrasonography. J Radiol. 2001;82(7):839–42.

    CAS  PubMed  Google Scholar 

  137. Biagiotti G, et al. Spermatogenesis and spectral echo-colour Doppler traces from the main testicular artery. BJU Int. 2002;90(9):903–8.

    CAS  PubMed  Google Scholar 

  138. Hillelsohn JH, Chuang KW, Goldenberg E, Gilbert BR. Spectral Doppler sonography: a noninvasive method for predicting dyspermia. J Ultrasound Med. 2013;32(8):1427–1432. doi:10.7863/ultra.32.8.1427.

    PubMed  Google Scholar 

  139. Schurich M, et al. The role of ultrasound in assessment of male fertility. Eur J Obstet Gynecol Reprod Biol. 2009;144(Suppl 1):S192–8.

    PubMed  Google Scholar 

  140. Li M, et al. The value of sonoelastography scores and the strain ratio in differential diagnosis of azoospermia. J Urol. 2012;188(5):1861–6.

    PubMed  Google Scholar 

  141. Hopps CV, Goldstein M. Ultrasound guided needle localization and microsurgical exploration for incidental nonpalpable testicular tumors. J Urol. 2002;168(3):1084–7.

    PubMed  Google Scholar 

  142. De Stefani S, et al. Microsurgical testis-sparing surgery in small testicular masses: seven years retrospective management and results. Urology. 2012;79(4):858–62.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Urology Consultants Ltd., Male Reproduction & Sexual Health, St. Louis, MO, USA

    Etai Goldenberg MD

  2. The Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, 450 Lakeville Road, Ste. M41, New Hyde Park, NY, 11040, USA

    Bruce R. Gilbert MD, PhD

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  1. Etai Goldenberg MD
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  2. Bruce R. Gilbert MD, PhD
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Correspondence to Etai Goldenberg MD .

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  1. Jewish Health System, The Arthur Smith Institute for Urology, New Hyde Park, New York, USA

    Bruce R. Gilbert

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Goldenberg, E., Gilbert, B. (2015). Scrotal Ultrasound. In: Gilbert, B. (eds) Ultrasound of the Male Genitalia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7744-0_4

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  • DOI: https://doi.org/10.1007/978-1-4614-7744-0_4

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