In November 1983, we surveyed 655 gay men in San Francisco regarding their sexual practices during the previous month and the same month one year ago. The sample was selected to include men in situations that would lead to high risk of sexual activities related to AIDS (acquired immune deficiency syndrome) transmission (i.e., men frequenting bathhouses and gay bars) as well as men in low-risk situations (those going to neither place and men in primary relationships). The Bath group showed little change in frequency of bathhouse use and in number of sexual partners from that location. The other groups showed substantial reductions in frequency of sexual contacts from bars, baths, T-rooms, or parks.

A study of 28 patients with surgically proved testicular tumors was performed to determine the appearance at color Doppler ultrasound (US) scanning. There was a general correlation of tumor size and vascularity. Twenty of 21 (95%) tumors larger than 1.6 cm were hypervascular. Six of seven (86%) tumors smaller than 1.6 cm were hypovascular. One small, 1.1-cm-diameter seminoma was hypervascular, and one 2.8-cm-diameter seminoma was hypovascular. The histologic findings of the tumor did not correlate with the vascularity of the lesion as seen at color Doppler US. Resistive indexes ranged from .476 to 1.0 (mean, 0.70). Peak systolic velocities ranged from 8.4 cm/sec to 64.9 cm/sec (mean, 9.8 cm/sec). Venous flow was detected in eight tumors. The gray-scale findings, as well as history and physical examination findings, correctly suggested a neoplasm in all cases. The findings at color Doppler US were prospectively interpreted as indicative of neoplasm in 27 cases and as indicative of inflammation in one case. The authors conclude that color Doppler US scanning has only a limited role in the evaluation of testicular tumors.

award for a scientific exhibit at the 1990 RSNA scientific assembly.

A study of 45 patients with 51 cases of hemiscrotal inflammatory disease was done to determine the color Doppler ultrasonographic appearance of scrotal inflammatory disorders. The diagnosis was ultimately established by means of appropriate response to antibiotic treatment (47 cases) or surgery (four cases). In all cases, there was evidence of hyperemia: an increased number and concentration of detectable vessels in the affected portion of the scrotum. In 17 cases, the gray scale images were normal, and the only evidence of inflammation was the presence of hypervascularity. Abnormally decreased epididymal vascular resistance was detected in 14 cases of epididymitis; abnormally decreased testicular vascular resistance was detected in six cases of orchitis. Spontaneous venous flow was present in 18 patients. The authors conclude that color Doppler can demonstrate the hyperemic response to scrotal inflammatory disease and that, in the proper clinical setting, it can supplement the gray scale findings and increase diagnostic confidence.

Incidental nonpalpable testicular masses were discovered in 9 patients during approximately 1,600 scrotal ultrasound examinations done for other indications. Of the 9 lesions 7 (78%) were benign (4 Leydig cell tumors, 2 Sertoli cell tumors and 1 interstitial fibrosis) and 2 (22%) were malignant (1 teratocarcinoma and 1 seminoma). Five lesions (55%) were less than 1 cm (4 benign and 1 malignant), while 4 (45%) were 1 to 2 cm (3 benign and 1 malignant). Seven lesions (78%) were hypoechoic, 1 (11%) was hyperechoic and 1 (11%) was cystic. We conclude that incidentally discovered nonpalpable lesions are usually benign. Management should include inguinal exploration with frozen section diagnosis. The testis can be spared if the lesion is benign. Ultrasound followup should be used only if there is a strong clinical suspicion of a nonneoplastic lesion, such as recent trauma or infection. It is suggested that nonpalpable tumors discovered in patients with metastatic germ cell tumor should be treated as malignant.