US Findings in the Scrotum of Extreme Mountain Bikers

Frauscher, Ferdinand; Klauser, Andrea; Stenzl, Arnulf; Helweg, Gernot; Amort, B; D, zur Nedden

doi:10.1148/radiology.219.2.r01ma42427

Cited by 67 publications

(52 citation statements)

References 22 publications

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“…Punctate epididymal calcification has been described in patients on maintenance hemodialysis, 3 and focal epididymal macrocalcification after chronic repeated microtrauma has been seen in extreme mountain bikers. 4 The foci of epididymal calcification in our case would be entirely consistent with microlithiasis on sonographic criteria, as described in the testis, and appear quite distinct from other previously described causes of epididymal calcification.…”

Section: Discussionsupporting

confidence: 89%

Sonographic appearance of epididymal microlithiasis

Vandervelde

Varghese

Mason

et al. 2007

J of Clinical Ultrasound

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We report a case of epididymal microlithiasis that was diagnosed sonographically in a 75-year-old man undergoing scrotal sonographic examination to investigate right groin pain associated with an inguinal hernia. The sonographic appearance was that of multiple comet-shaped foci of microcalcification throughout both epididymides, with associated comet-tail artifacts. The testes had normal appearance with no evidence of testicular microlithiasis. The patient subsequently remained well after hernia repair. To our knowledge, epididymal microlithiasis has only previously been reported in a cadaveric study; the authors of that study hypothesized that the condition is caused by aging, with ischemia likely implicated in the pathogenesis. There are many other patterns of extratesticular calcification, including sperm granuloma, hematoma, and chronic epididymitis. We discuss how these differ in appearance from epididymal microlithiasis. Epididymal microlithiasis is a completely separate entity from testicular microlithiasis and should be recognized and dismissed by sonographers and radiologists.

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Section: Discussionsupporting

confidence: 89%

Sonographic appearance of epididymal microlithiasis

Vandervelde

Varghese

Mason

et al. 2007

J of Clinical Ultrasound

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“…Frauscher et al (6) and Artas and Orhan (1) found the mean diameters of scrotal calculi to be 4±3 mm (range, 2-14 mm) and 4.22±2.42 mm (range, 2-10 mm), respectively. In our study, we found the mean size of the scrotal calculi to be 3.7±1.4 mm (range, 1.6-7.0 mm), which is similar to the sizes reported previously.…”

Section: Discussionmentioning

confidence: 98%

“…However, repeated chronic microtrauma to the scrotum may be a risk factor for the development of calculi. Frauscher et al (6) and Turgut et al (7) reported the existence of scrotal calculi in 81% of extreme mountain bikers and 7% of equestrians, respectively. In our study, the frequency of scrotal calculi was 1.95% from a total of 3435 men who had been consecutively recruited from the surgical and internal medicine clinics.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of scrotal calculi and its relationship to pain

Tan

Ozcan²,

Karaoğlanoğlu³

et al. 2011

Diagn Interv Radiol

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303T he presence of scrotal calculi is a relatively rare condition that is characterized by the presence of freely mobile calcified bodies between the layers of the tunica vaginalis of the testes, which are often found in patients who have been referred for scrotal ultrasound (1). The etiology of the scrotal calculi is uncertain. However, inflammatory changes within the remnants of the appendix, testis or epididymis may play a role in the development of these types of calculi (1, 2). There are a limited number of studies on scrotal calculi in the literature, and most of these are case reports. Furthermore, to our knowledge, no clinical trial has focused on whether there is a relationship between scrotal calculi and pain.The purpose of this large series study was to determine the frequency of scrotal calculi in men who were referred for scrotal ultrasound, and to identify any associated pathologic conditions in order to investigate whether any relationship exists between the presence of scrotal calculi and pain. Materials and methodsThis research was approved by the institutional human ethics committee at our hospital. A retrospective review of the radiology data processing system database revealed the existence of 4084 ultrasonography (US) scrotal reports from 3435 men between January 2008 and February 2011.US examinations were performed using US equipment with a 9-14 MHz linear probe (Logic9, GE Healthcare, Milwaukee, Wisconsin, USA) and with an 8-14 MHz linear probe (Technos MPX, Esaote, Genoa, Italy). US examinations were performed by two radiologists who were experienced in ultrasound techniques. The examinations were performed while the patient was lying in the supine position. The scrotum was immobilized prior to the application of a small amount of gel, and the US scans were performed in the transverse, longitudinal and multiple oblique planes. In this study, the patient information and the US findings were obtained from the US reports. These reports had been recorded in the radiology information system and we evaluated each of the scrotal US reports.Scrotal calculi were defined as typical round or oval echogenic foci with or without acoustic shadowing that were located between the layers of the tunica vaginalis of the testes (Fig. 1). Additionally, scrotal abnormalities, such as the presence of hydrocele or varicocele, or any other testicular or epididymal abnormalities that were reported during the scrotal US examination, were noted.Following the identification of scrotal calculi from the US reports, a total of 67 patients were contacted by phone, and 40 patients were interviewed. Subsequently, patients were asked whether they had any scrotal PURPOSEThe purpose of this study was to determine the frequency of scrotal calculi in men referred for scrotal ultrasonography (US), to identify any associated pathologies, and to investigate if any relationship exists between scrotal lithiasis and pain. MATERIALS AND METHODSThis was a retrospective study in which 4084 scrotal US examinations in 3435 men were eval...

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“…A study by Frauscher and colleagues, performing ultrasound testing, reports that mountain bikers show greater incidence of scrotal and testicular abnormalities as compared to non-bikers [108]. Among the observed abnormalities, some should be highlighted: testicular calcifications, hidrocele, varicocele, and testicular microlithiasis.…”

Section: Exercise and Testicular Microtraumamentioning

confidence: 98%

Is There a Link between Exercise and Male Factor Infertility?

Plessis¹,

Kashou²,

Vaamonde³

et al. 2011

TORSJ

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Abstract:The beneficial effects of physical exercise on general health are well known; however, as exercise imposes great physical stress that challenges homeostasis, it can be detrimental to certain organs/systems of the body when it is exhaustively performed. Decreased seminal parameters and sex hormone levels have been reported in male athletes and, therefore, a possible impairment of male fertility has been linked to exercise in a volume, intensity, and modality dependent-manner. Also, inherent characteristics of sportsmen (e.g. training level, adaptive capacity) may modify the response. This article aims to review the relevant literature regarding exercise and male factor infertility, while at the same time explores the possible underlying mechanisms that might be involved in this observable fact.

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US Findings in the Scrotum of Extreme Mountain Bikers

Abstract: US shows a significantly higher prevalence of extratesticular and testicular disorders in these mountain bikers compared with nonbikers.

Cited by 67 publications

References 22 publications

Sonographic appearance of epididymal microlithiasis

Sonographic appearance of epididymal microlithiasis

Prevalence of scrotal calculi and its relationship to pain

Is There a Link between Exercise and Male Factor Infertility?

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