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Abstract

Objective: To determine the Ultrasonographic appearances in patients with tuberculous Epididymo-Orchitis and Orchitis and to correlate them with the histopathological findings. Materials and Methods: Total 25patients with 50 hemi scrotums of clinically suspected Epididymo-Orchitis and Orchitis with high suspicion of tubercular aetiology were assessed on ultrasonography. Of these 50 hemi scrotums, 12 scrotums of 8 patients testicular and epididymal tissues cultures were positive for Mycobacterium tuberculosis. Results: The most detected sonographic findings of tuberculous epididymitis were an enlarged epididymis commonly in the tail region, and marked heterogenous echo texture of the involved epididymis. Sonographic findings of testicular involvement consist of an ill defined focal intratesticular hypoechoic area or diffusely enlarged hypoechoic testis or an irregular margin between the testis and epididymis. In our study Unilateral Epididymo-Orchitis is the most common involvement pattern followed by isolated epididymitis, bilateral Epididymo-Orchitis and isolated orchitis respectively. The sonographic appearances in patients with tuberculous epididymitis are seen to be different from those encountered in nontuberculous epididymitis. Conclusion: Adequate evaluation of patients with high suspicion of Tuberculous Epididymo-Orchitis and Orchitis, by means of scrotal ultrasound coupled with fine needle aspiration cytology is critical to diagnostic accuracy and optimal treatment. Ultrasound significantly helpful to the initial assessment and future management of the patient with follow-up scans ensuring positive response to treatment thereby avoiding surgical intervention.