Ultrasound examination of the scrotum in boys

BACKGROUND: Ultrasound examination is applied in the objective evaluation of size of scrotal structures as well as in diagnosing focal and inflammatory lesions in testes and epididymis. AIM: The aim of our study is to point out the necessity and significance of the ultrasound in diagnostics of abnormalities within the scrotum in boys. MATERIAL AND METHODS: The examination included 180 boys, aged 2-17 years, referred because of gynecomastia (70), cryptorchism (45), precocious puberty (11), palpable thickenings of the spermatic cord (30) and asymmetry of testicular size (24). Ultrasound examination was carried out with Acuson 128 XP, linear transducer 7.5 MHz, along with color flow Doppler (and/or Sequoia, linear transducer 8-15 MHz). RESULTS: Testes in the inguinal canals at different levels were visualised in all boys with unilateral or bilateral cryptorchism. Varicocele were seen in 19 boys with gynecomastia, epididymal cysts in 10, microlithiasis in 3 cases. Testicular volume in boys with precocious puberty exceeded 2 SD, additionally there was microlithiasis in one patient, in 2 patients varicocele and in one boy tumor was found (Leydig's cell tumor). Varices were left-sided in 95% boys with varicocele, in 5% they were bilateral at different stage. Additionally in one patient hygroma of the spermatic cord was found. Asymmetry of testicular size was caused by hydrocele in 16 patients and varicocele in 8 cases. CONCLUSIONS: Ultrasound is supplementary to the physical examination of testes, and in many cases it enables to reveal lesions inaccessible in the clinical examination. Considering its non-invasive character and high-resolution, ultrasound is a useful imaging method of the scrotal structure in children.