Scrotal US for Pain Rarely Reveals Absolute Surgery Indications

Study shows that 81% of scrotal ultrasounds for pain demonstrate normal or benign findings.
Study shows that 81% of scrotal ultrasounds for pain demonstrate normal or benign findings.

NEW ORLEANS—Scrotal ultrasound (US) examinations performed to evaluate scrotal pain usually reveal normal or benign findings and very rarely find absolute indications for surgery, a researcher reported at the 2015 American Urological Association annual meeting.

James Kashanian, MD, of Northwestern University's Feinberg School of Medicine in Chicago, presented the findings of a study of 7,668 scrotal US examinations performed for scrotal or testicular pain, ache, or discomfort. Of these, only 121 (1.5%) revealed findings that are absolute indications for surgery. In 1,281 cases (16.7%), US demonstrated an inflammatory or infectious process. A total of 2,600 (33.9%) US examinations found no abnormalities and 3,616 (47.2%) demonstrated benign findings.

In addition, 54 US examinations (0.70%) showed a scrotal or testicular abscess; 60 (0.78%) demonstrated a discrete mass suspicious for neoplasm; 12 (0.16%) had findings consistent with a testicular infiltrative process suspicious for sarcoid, leukemia, or lymphoma; and 45 (0.59%) were found to have a diagnosis of torsion or torsion/detorsion, Dr. Kashanian said.

“The indications for scrotal ultrasound, we believe, can be used to stratify the risk of malignancy in testicular masses found,” Dr. Kashianian told attendees.

He and his colleagues believe their data set represents the largest to date addressing findings on scrotal US performed for pain.

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