Ultrasonography of the scrotum can be done using a sector scan probe or a linear array probe. High MHz probes are desired to increase the resolution of the tissues being imaged. Care should be taken to identify and assess each structure. The testicles should reveal a homogenous tissue texture on ultrasound. Hyperechoic (brighter on the image) or hypoechoic (darker on the image) lesions in the testicles or epididymides may indicate trauma, infection, cysts, or other abnormal conditions that may affect fertility. A diseased testicle may cause suppression of the normal testicle so that the fertility of the male is impaired. The head and tail region of the epididymis can be identified by the cluster of tubules. The tubules are recognized as multiple hypoechoic foci arranged in a concentric area at each end of the testicle. The body of the epididymis is difficult to follow and assess.

Testicular biopsy or fine needle aspiration can be performed to assess ultrastructure and determine prognosis for fertility. The procedures are not recommended to be done on the epididmi because of the risk of fibrosis and obstruction of the tubules. However, these procedures can be successfully done on the testicles with minimal risk. Biopsy of the testicle allows for histopathologic examination of the tissue architecture. This aids in establishment of prognosis by examination of the germinal epithelium. Fine needle aspirates provide samples sufficient to establish if active spermatogenesis is occurring and to allow for culture of the tissues when orchitis is suspected.

Stay updated, free articles. Join our Telegram channel

Join