Ultrasonography in Predicting the Cause of Scrotal Pain: A Study in Nepal

Subash K C^1, , Mahesh Pathak¹, Abhijit De² and Brijesh Sathian³

¹Department of Radiodiagnosis & Imaging, Manipal Teaching Hospital, Pokhara, Nepal

²Medical Officer, Park Clinic, Kolkata, India

³Department of Community Medicine, Manipal College of Medical Sciences, Pokhara, Nepal

Cite this paper:
Subash K C, Mahesh Pathak, Abhijit De and Brijesh Sathian. Ultrasonography in Predicting the Cause of Scrotal Pain: A Study in Nepal. American Journal of Public Health Research. 2015; 3(5A):199-202. doi: 10.12691/ajphr-3-5A-42

Abstract

Ultrasound is an easily available, less time consuming, reproducible and safest imaging modality in evaluation of scrotum. It is important to come to an accurate diagnosis in any case of scrotal pain. Although epididymitis with or without orchitis is commonly encountered, it is necessary to rule out emergency conditions like torsion of spermatic cord not only to salvage testes with timely surgery but also to avoid negative surgeries on otherwise inflammatory conditions. This study was done in Manipal Teaching Hospital situated in western region of Nepal on 100 cases presenting with scrotal pain. It was done over a period of 2 years from September 2013 to August 2015. Various causes of scrotal pain were accurately diagnosed in all the included cases. Prevalence of various common causes of scrotal pain were depicted by this study. Epididymitis was noted in 35% cases with scrotal pain, followed by varicocele in 15 % cases and epididymo-orchitis in 12 % cases. Most patients were in 20 to 30 years age group comprising 41 % followed by 31to 40 years age group comprising 39%. Hence, scrotal USG is a valuable tool in diagnosing cause of scrotal pain more so in clinically equivocal cases.

Keywords:
ultrasonography scrotal pain

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Figures

References:

[1]	Davis JE, Silverman M. Scrotal emergencies. Emerg Med Clin North Am. 2011; 29(3):469-484.
[2]	Lam WW, Yap TL, Jacobsen AS, Teo HJ. Colour Doppler ultrasonography replacing surgical exploration for acute scrotum: myth or reality? Pediatr Radiol. 2005; 35(6):597-600.
[3]	Beni-Israel T, Goldman M, Bar Chaim S, Kozer E. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010;28(7):786-789.
[4]	Chhetri P.K et al Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-1, 18-22.
[5]	Sathian B, Sreedharan J, Baboo NS, Sharan K, Abhilash ES, Rajesh E. Relevance of Sample Size Determination in Medical Research. Nepal Journal of Epidemiology 2010; 1(1):4-10.
[6]	Haider Najim Aubaid et al. Sonographic Findings in Scrotal Swellings. Journal of Kerbala University, 2014; 12 (2). 2014.
[7]	Arger PH, Mulhern CB, Jr. Coleman BG. et al. Prospective analysis of the value of scrotal ultrasound. Radiology 1981;141:763-6.
[8]	Richie JP, Birnholz J, Garnick MB. Ultrasonography as a diagnostic adjunct for the evaluation of masses in the scrotum. Surgery-Gynecology-Obstetric, 1982;154:695-8.
[9]	Minayoshi K.E., Okoda 14.1., Fujisawa M.A., et al. Hemodynamic evaluation of left testicular varicocele by scrotal scintigraphy. Eur. Urol 2001; 39: 030-035.
[10]	Meacham RB, Townsend RR, Rademacher D, Drose JA. The incidence of varicoceles in the general population when evaluated by physical examination, gray scale sonography and color Doppler sonography. J Urol 1994; 151: 1535-8.
[11]	Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the Scrotum. Radiology 2003; 227: 18-36.
[12]	El-Saeity NS, Sidhu PS. "Scrotal varicocele, exclude a renal tumour". Is this evidence based? Clin Radiol 2006; 61: 593-9.
[13]	Wolverson MK ,Houttuin E ,Heiberg E, Sundaram M, Gregory J American Journal of Roentgenology1983 Oct;141(4):775-9.
[14]	Rifkin MD, Kurtz AB, Goldberg BB. Epididymis examined by ultrasound:correlation with pathology. Radiology 1984;151:187-90.
[15]	Howlett DC, Marchbank ND, Sallomi DF. Ultrasound of the testis. Clin Radiol 2000; 55:595-601.
[16]	Grantham JG, Charboneau JW, James EM, Kirschling RJ, Kvols LK, Segura JW, et al. Testicular neoplasms: 29 tumors studied by high-resolution US. Radiology 1985; 157: 775-80.
[17]	Horstman WG, Melson GL, Middleton WD, Andriole GL. Testicular tumours: Findings with color Doppler US. Radiology 1992; 185: 733-7.
[18]	Bushby LH, Sriprasad S, Hopster D, Muir G, Clarke JL, Sidhu PS. High frequency colour Doppler US of focal testicular lesions: crossing vessels (criss-cross pattern) identifies primary malignant tumours. Radiology 2001; 221: 449.
[19]	Sidhu PS, Sriprasad S, Bushby LH, Sellars ME, Muir GH. Impalpable testis cancer. BJU International 2004; 93: 888.
[20]	Tiemstra JD, Kapoor S. Evaluation of scrotal masses. Am Fam Physician 2008; 78: 1165-70.
[21]	Middleton WD and Melson GL Testicular ischemia: color Doppler sonographic findings in five patients American journal of Roentgenology. 1989; 152: 1237-1239.
[22]	Subramanyam BR, Horii SC and Hilton S. Diffuse testicular disease: Sonographic features and significance. American Journal of Roentgenology. 1985; 145: 1221-1224.
[23]	Gorman B, Caroll BA. The scrotum. In: Rumack CM, Wilson SR, Charboneau JW, editors. Diagnostic Ultrasound, 3rd edition. St Louis, MO: Elsevier Mosby, 2005. p.849-88.