When is this exam indicated?
Testicular ultrasound plays an important role in the diagnosis of a variety of conditions. It allows to detect the occurrence of endo-scrotal liquid collections, which can be a condition known as hydrocele that may require surgical treatment. It allows to evaluate the testicular ecostructure, assessing morphology, size, the presence of calcifications (often of non-pathological significance) and the presence of any suspicious nodules in a neoplastic sense. In this case, ultrasonography assumes a fundamental role in guiding the diagnosis, allowing to identify the location of the nodule (intra or extra testicular), to assess its size and vascularization with Doppler method. Testicular ultrasound can also provide relevant information in case of patients with acute testicular pain, ensuring the differential diagnosis between two different pathological conditions, but that may occur with a similar symptomatological cortex: orchitis and torsion of the spermatic cord. Orchitis is a simple inflammation of the testicular tissues usually sustained by a local or diffuse infection of the urinary tract. In this case, the ultrasound will show an increase in volume of the testicle affected by the inflammatory picture compared to the contralateral, with increased thickness of peri-testicular tissues and vascular signals with Doppler method. In the case of torsion of the spermatic or testicular funiculus, on the other hand, the ultrasound will show the presence of a testicle of usually preserved size, with a decrease or, in severe cases, complete absence of testicular vascularization. The latter case is a urological emergency that requires a rapid evaluation by the physician and possibly a surgical correction. Finally, testicular ultrasound in pediatric age enables, together with the clinical finding of scrotal palpation, to make the diagnosis of cryptorchidism.
How is it performed?
The examination requires an ultrasound apparatus equipped with a linear probe and the possibility of observation in the form of colored images of blood flows, using the physical phenomenon called "Doppler effect".