What is a testicular ultrasound and when is it necessary?

A testicular ultrasound is simple and painless, so it does not have any complications. Learn all about this method available in almost all clinics.

Written and verified by the doctor Mariel mendoza on September 09, 2021.

Last update: 09 September, 2021

Testicular ultrasound is a medical test that It is used for the purpose of obtaining images of the testicles and the surrounding tissues of men. It is also called ultrasound or sonography, inasmuch as it uses high-frequency sound waves.

It is a safe, simple, painless, non-invasive imaging study method that does not require prior preparation. It also has no complications or risks. Here we tell you when it is necessary.

Anatomy of the area

The testicles are part of the male reproductive system. Its function is to produce sperm and testosterone, which is the male sex hormone.

There are two testicles and they are located in the scrotum, a tissue bag that is found under the penis. Usually the left is lower than the right. Its size ranges between 4 and 5 centimeters long axis and 2 to 3 centimeters wide. The normal volume is 30 milliliters.

At the back of the testicles is a tube called epididymis, which is responsible for storing and transporting sperm. In turn, the testicles are connected to the rest of the body by the spermatic cord, which contains an artery, a vein and the vas deferens, through which semen circulates from the testicles to the urethra.

Basis of ultrasound

Ultrasound is a study method that uses high-frequency sound waves to produce images of organs. The ultrasound system consists of 3 parts: transducer, processing unit, and screen. The transducer is a portable device capable of sending inaudible high-frequency sound waves into the body.

The transducers emit the sound waves and capture the reflection or rebound produced by the tissues. This enables the processing unit to produce a gray-scale image on the screen.

Depending on the characteristics of the waves, the image will be more or less bright, which will be interpreted by the radiologist or the ultrasound technician. What's more, there is the option to provide still or moving images in real time.

Ultrasound uses ultrasound to generate images. Currently, there are color options.

When is testicular ultrasound recommended

A doctor may recommend a testicular ultrasound for different reasons. Among them, the most important are the following:

  • Check if a mass in the scrotum or testicles is solid (tumor) or is filled with fluid (cyst).
  • Check the effect of direct trauma to the scrotum or testicle.
  • Identify the causes of pain or swelling of the testicles.
  • Check for causes of infertility.
  • Locate a testicle that has not descended.
  • Assess testicular blood circulation.

Testicular ultrasound procedure

Testicular ultrasound does not require any type of previous preparation. There are no specific foods forbidden or consumption of liquids to have a full bladder. Neither is the suspension of any medication necessary.

During the procedure

The procedure will be performed by a sonographer or radiologist. It will be done in your office or in the radiology department.

It takes 20 to 30 minutes. The patient will be in a dark room for a better visualization of the images. You will be asked to remove any clothing from the waist down.

You should be lying on your back, with your legs apart. In the case of testicular ultrasound, the scrotum should be slightly elevated, so sometimes a towel is placed in the lower area. Subsequently, a warm water-based gel is applied that allows the transducer to slide off.

Gliding is done with back and forth movements, varying the angle. It is not painful, but it can create a feeling of pressure. In some cases, there is discomfort to be on a sensitive area or with some abnormality.

Post procedure

Immediately, the patient can return to their usual activities. It does not require any recovery time.

The results will first be observed and analyzed by the sonographer or radiologist who performed it. They will then be sent to the treating doctor.

Possible results of testicular ultrasound

The anomalies found may vary. It is possible to detect a testicular infection, a benign cyst, a testicular torsion or tumor, hydrocele, epididymitis, or spermatocele.

In the case of the presence of a testicular mass, when it is of liquid content (cyst) they are generally benign. While in the case of solid content (tumor), malignant processes must be ruled out.

Testicular torsion occurs when the spermatic cord becomes twisted and does not allow blood to flow to the testicles, creating an urgent medical condition that can cause tissue death if not treated in time. It usually manifests with pain of strong intensity without cause and its resolution is surgical.

Epididymitis or inflammation of the epididymis can cause a testicular mass, pain, and inflammation. The hydrocele, on the other hand, is caused by the accumulation of fluid in the tissue that lines the testicle. Spermatocele usually produces a painless testicular mass, whose content is seminal fluid.

Undescended testicles are found in babies after 6 months of age. In general, they do not manifest any other symptom other than the absence of the testicle in the scrotal bag.

Dilation of the testicular veins is called varicocele. It can present with testicular pain, atrophy or sterility.

Trauma can generate hematomas or alterations in the testicular anatomy that are studied with ultrasound.

Limitations of testicular ultrasound

This ultrasound is useful for finding abnormalities, such as scrotal or testicular masses. But it does not always allow an exact diagnosis, since it does not let us know what the type of tissue of a solid mass is.

Secondly, blood flow images are not always reliable. And in the case of absent testicles, they may not be found if they are intra-abdominal, as gas-distended intestinal loops block view.

In any case, testicular ultrasound is a painless, non-invasive, easily accessible and risk-free method of study. This justifies its use as first line in the diagnosis of abnormalities in the testicles and adjacent tissues.