Evaluation of Spectrum of Scrotal Pathologies using High Resolution Ultrasound

Abstract

The scrotum and its contents are normally accessible for clinical examination under normal conditions. Physical examination may be limited by tenderness or swelling. Gray scale and Doppler ultrasound imaging supplements the clinical examination, as an accurate means of evaluating diverse scrotal diseases. It permits differentiation between the lesions like torsion that require urgent surgical management from orchitis which can be managed conservatively. Material and methods: The study was conducted on 70 patients presenting to the outpatient department of Mysore Medical College and Research Institute, Mysore with symptoms pertaining to the scrotum during a period of 12 months. They were subjected to scrotal ultrasound examination. Frequency and proportion were calculated using Epi Info TM for Windows version 7. Results: The most commonly involved age group was 31 to 40 years (n = 23; 32.9%). Swelling was the most common symptom. On USG, the most common scrotal pathology encountered was hydrocele (n=22; 19.80%) followed by epididymal cyst (n=18; 16.2%), epididymo-orchitis (n=15; 13.60%) and epididymitis (n = 10; 9%). The pathologies were more common on left side (n=48, 43.24%). Conclusion: High frequency ultrasonography with Color Doppler study serves as an excellent diagnostic imaging modality in the evaluation of scrotal diseases. It is the investigation of choice since it is highly sensitive, easy to perform, widely available, repeatable and involves no risk of ionizing radiation. Periodic follow-up USG scans are recommended for patients with inflammatory scrotal lesions to monitor response to treatment and to reveal the development of complications.