Blanks for ultrasound examination of the scrotum. Organs of the scrotum. Template (example, form) of an ultrasound protocol for ultrasonic description of the normal echostructure of the scrotal organs. In what cases is ultrasound prescribed?

Revealing urological diseases The male genital area is rarely complete without an ultrasound examination of the scrotum. In the study of pathologies in this area of the body, ultrasound has no analogues, since the organs being studied are located in hard to reach place. When and why a person might need an ultrasound of the scrotum, and how exactly the procedure goes, we will tell you in this article. In addition, we will consider the need to prepare for manipulation and decrypt scan data.

Ultrasound of the scrotum is usually prescribed by a urologist, less often by a surgeon. If a doctor writes a referral to an ultrasound diagnostic room, there is a high probability that he has suspicions of pathology of the genitourinary system.

Additionally, the doctor may recommend examination of adjacent vessels. For example, if there is torsion of the spermatic cord (the second name is testicular torsion), then Dopplerography is mandatory (ultrasound with Doppler, color Dopplerography - Color Dopplerography). So, here is the basis for prescribing an ultrasound of the scrotum:

difficulty conceiving, such as established diagnosis“infertility”, and if it is suspected;
enlargement of the testicles or scrotum;
lack of erection and inability to achieve it;
swelling and pain in the scrotum area;
development of inflammation in this area or suspicion of it, including when making diagnoses such as orchitis, orchiepididymitis, epididymitis;
an urgent indication for scanning the scrotum is its injury, bruise and hematoma formation;
neoplasms;
violation of the norms of puberty in adolescents;
questionable spermogram results;
sometimes with inflammation of the inguinal lymph nodes (this may be a symptom of certain diseases);
varicocele, actual or suspected;
absence of one or both testicles;
hormonal disorders and endocrinological diseases;
presence and fears due to its advancement into the scrotum;
undergone urological surgery or during preparation for it.

What are they watching?

Scrotal scanning is the most modern, fastest and most accurate diagnostic method. Ultrasound of the male genital area reveals:

any pathologies, including those in the formative stage;
scrotal injuries;
causes of discomfort and pain in this area;
causes of potency problems.

The procedure provides a valuable opportunity to find out and shows the condition of the organs (testicles; sometimes additional examination of nearby organs may be prescribed - for example, prostate gland, ), evaluate their parameters (maturity, potential and size), as well as non-compliance with accepted standards (anomalies, tumors, edema, etc.).

Reference! Additional uses Dopplerography allows you to examine in detail the features of blood vessels and evaluate blood flow parameters.

Ultrasound of the scrotum is included in the complex mandatory examinations for men who have difficulty conceiving.

Video

This video talks about what an ultrasound of the scrotum helps to identify.

Preparation

If an ultrasound scan of the scrotum is prescribed, the adult patient should know that no special preparation is required. If we are talking about a child, then parents must prepare him, explaining the essence of the manipulations and justifying their necessity.

Important! Before the ultrasound, both adults and children should take a shower or bath and follow all hygiene measures.

Most children perceive examinations negatively intimate organs, so do not neglect a detailed conversation on the eve of the procedure.

How do they do it?

The examination is carried out by a diagnostician using special equipment with a sensor. high frequency. The patient lies on his side or back, and the area to be examined is covered with a conductive gel, which is applied liberally to the skin.

Then the doctor moves the sensor over the skin, pressing it more tightly in the places of interest to the specialist. If all parameters fit into the normal range, then all manipulations will take no more than 15 minutes. But if the sonologist suspects pathologies or sees deviations from the norm, then the procedure may take half an hour.

It is possible to refer the patient from the ultrasound room directly to the urologist or surgeon's office for subsequent consultations. Sometimes even non-invasive and completely comfortable procedures can pose a risk to the health of the male genital area.

Norms and decoding

During the procedure, the doctor can immediately report the abnormalities he finds, but only the attending doctor can answer in detail and accurately all questions related to the ultrasound results, diagnosis and subsequent treatment.

On the ultrasound machine monitor normal scrotum looks like echogenic tissue, consisting of several layers of different thickness and density. During the scan, its front and back parts are examined.

Appendix 1. Ultrasound form of the scrotum.

For the doctor, the parameters (size and shape) of the testicles, as well as the uniformity of their structure, are important. Moreover tissue density depends on age: in children it is lower and will approach the parameters of an adult only during puberty.

The anatomy of the scrotum consists of two testicles, each of which has its own spermatic appendage, conventionally divided into a body, tail and head. In normal spermatic cord vessels are located, including lymphatic ones, as well as the vas deferens.

Pathologies

An approximate diagnosis can be made by a diagnostician during the scanning process, but the urologist must clarify it based on consultations and tests.

During the examination of the scrotum in children, the following is revealed:

Dropsy (another name is hydrocele) of congenital or acquired form.
Hypogonadism is a lack of gametogenesis and a decrease in androgens. The disease is typical for young children, the body healthy person independently produces the necessary components.
Undescended testicle into the scrotum, which is not considered a pathology until a certain age and does not require correction. Characteristic of the newborn period and with age the condition normalizes.
Calcifications.
Manifestations inflammatory processes.
Cysts and tumors (very rare for children).

Adult patients are characterized by their own manifestations of pathologies, for example, in men, ultrasound makes it possible to identify:

epididymitis;
the presence of lymph, blood or water in the scrotum, which may result from inflammation or injury;
purulent inflammation of the appendage;
injuries, both open and closed;
testicular cysts or tumors;
infertility.

Contraindications

The only hindrance to the research is impaired skin in the scrotum area.

Advantages and disadvantages

There is an opinion that ultrasonic waves are harmful to the body, and they are especially harmful to the child in the womb and to the genitals. However, these rumors have not yet been scientifically confirmed and there is no evidence that male sexual functions can be affected by repeated ultrasound radiation.

A similar, but less informative diagnostic method is radiography, a much less gentle procedure that uses X-rays.

Where to do it and how much does it cost?

Price ultrasound examination scrotums – from 900 rub. This figure varies depending on the region of residence of the patient and the prestige of the clinic. Ultrasound of the scrotum is available both in city clinics (as prescribed by a doctor) and in private medical centers (at the request of the patient).

Conclusion

Ultrasound examination of the scrotum is very important element diagnostics if there are any complaints from the patient about the condition of the groin organs.

You should not ignore the procedure, because... only its implementation will help the specialist to deliver accurate diagnosis and you need to prescribe treatment.

A scrotal ultrasound is a procedure that examines the scrotum using high-frequency ultrasound waves to see its internal structure. This method refers to the primary diagnostic measure that helps identify the presence of pathologies in men’s health.No need to talk about the importance early detection diseases, since our health and life expectancy directly depend on this.

What are the indications for the study?

Ultrasound of the scrotum is prescribed in the following cases:

male infertility
an increase in the size of the epididymis and testicle
erectile dysfunction (inability to achieve an erection)
pain in the scrotum and swelling
suspicions of inflammatory diseases testicles and scrotum (orchitis, epididymitis, orchiepididmitis)
organ injury (hemorrhage, hematoma, tissue damage)
the appearance of tumor-like formations in the testicle and outside it
a decrease in one or both testicles in size, which is accompanied by sagging of the scrotum on one or both sides, respectively
puberty ahead of schedule, or, conversely, the presence of signs of its slowdown
change in spermogram readings
swollen lymph nodes, which may indicate the presence of a malignant tumor in the testicles
suspicion of varicicol
surveillance of previously detected tumors, infections and leukemias
Cryptorchidism is an abnormality of the testicles, characterized by their absence (one or both at once) or non-standard position in the groin area
endocrine diseases
suspicions of inguinal hernia with partial entry into the scrotum
monitoring the condition of the organ after operations performed on it.

If it is necessary to assess the condition of the scrotum and blood flow parameters in it, vascular bridle scrotum The procedure allows us to identify the true factors that caused many diseases (for example, varicocele).

It is also possible to accurately determine the presence of testicular torsion. At regular ultrasound this pathology is not detected accurately. Dopplerography of the scrotum is a completely accessible and informative study.

Do you need any preparation for this procedure?

No special preparation is required for scrotal ultrasound. The only condition for performing this study is hygienic treatment of the genital organ.

Sequence of the study

How to do an ultrasound of the scrotum:

the patient lies on the couch, on his back or on his side
A special gel is applied to the scrotum area, which helps to establish safe contact between the patient’s skin and the ultrasound machine.
The scrotum is examined using an electromagnetic sensor.

What ultrasound indicators are normal?

In the absence of pathologies, the following examination criteria and characteristics must be present in the protocol of this study:

Testicles:

are determined
size: for an adult man it should be 3-5 cm in length, 2-3 cm in width
contours: smooth, clear
Availability additional education: not detected.

Appendages:

head size: no more than 10-15 mm
tail and body: not visible
echostructure: homogeneous, isoechoic
contours: clear, even
the presence of additional formations was not detected.

Free liquid:

homogeneous
the amount is within normal limits (1-2 ml).

Scrotum:

wall thickness no more than 8 mm.

Interpretation of the study for pathologies

Ultrasound results of the scrotum in the presence of various diseases:

Epididymitis:

an increase in the size of the head of the epididymis with a change in its structure
the tail and body of the appendage may be visible
the presence of fluid in the scrotum is possible (a similar pathology can be observed with: hydrocele, lymphocele, hematocele).

Abcess of the appendage:

the presence of a space-occupying formation with uneven contours and reduced echogenicity
pockets of rarefaction with the same uneven edges are visible.

Closed injury:

uneven contours of the testicles and their irregular shape
heterogeneity of echostructure
presence of liquid at the site of damage.

Adnexal cyst:

the presence of a clear round formation, inside of which liquid is visible
the septum in the cyst is visible.

Testicular tumor:

irregular shape
the presence of voluminous formations of increased or decreased echo density, both in the testicle itself and beyond it
increased volume of fluid in the scrotum.

Infertility:

Cysts of the epididymis and spermatic cord are detected, compressing the vas deferens.

Are there any risks from performing an ultrasound?

The ultrasound waves used for the procedure are not radiation, therefore There is no harm caused by this research.

Ultrasound of the testicles in men is an ultrasound procedure for examining the shape and composition of the scrotum and testicles. Ultrasound allows you to obtain information about the presence of changes in the organs being examined to make a diagnosis or monitor the effectiveness of treatment.

Possible pathologies

Cryptorchidism (absence of testicles in the scrotum)

If the testicles cannot be palpated on one or both sides, the child is referred for an ultrasound. A hidden testicle can be detected in a child if its linear size is more than 10 millimeters. Cryptorchidism is characterized by homogeneity of the organ structure, and therefore, if any inclusions are present, a malignant formation must be excluded. If the testicle is missing from the scrotum, the newborn baby's inguinal canal, the area near the root of the penis, is examined. If the gonads are not found, the child is sent to geneticists to conduct a biochemical study and determine the karyotype.

The reason for prescribing an ultrasound of the testicles in a child may be not only cryptorchidism. Ultrasound is also prescribed for such disorders as: dwarfism, gigantism, excess weight, pathological hair growth, delay in physical or mental development child, birth defects hearts.

Tumors

Ultrasound examination makes it possible to identify formations in the primary stages. Typically, tumors are benign. In boys under 15 years of age, a malignant testicular tumor is usually the result of metastasis from lymphomas and leukemia. Cryptorchidism, trauma, pathological discharge gonadotropins, Carney syndrome.

Since the pain syndrome with this type of tumor usually appears on late stages, Ultrasound is recommended at the slightest suspicion, even in the absence of changes in the organ that can be palpated.

Stones

The condition can develop as a consequence of cryptorchidism, chemotherapy, or chromosomal disease. During ultrasound examination, calcifications are defined as echo-positive inclusions of high visibility.

Orchitis

With this disease, the testicles are enlarged due to their swelling. Orchitis usually occurs as a result of injury or infection of testicular tissue. The infection enters the gonads from the prostate gland or Bladder. Before the onset of puberty, a child is likely to have isolated orchitis, when the tissue becomes infected through the bloodstream.

Read also: Causes of thrush in the mouth

At acute inflammation Ultrasound examination shows an enlarged organ with a homogeneous internal structure. Severe inflammation causes marked swelling and heterogeneity or a homogeneous decrease in echo density.

Dropsy

With a hydrocele, fluid accumulates between the membranes. A sign of pathology is the accumulation in the scrotal cavity of echo-negative contents with a homogeneous structure, with a clearly visible testicle, epididymis and scrotal septum.

Injury

Ultrasound examination allows to identify conditions requiring emergency surgical care. In case of organ rupture, with extensive hemorrhage, this makes it possible to prevent ischemic atrophy or abscess.

Spermatocele

A retention cyst is a painless formation on the spermatic cord of a man. An ultrasound is performed to rule out a malignant tumor (if it is small in size) or dropsy (if the formation is large).

Epididymitis

Acute inflammatory process in the epididymis is a common cause of severe pain syndrome and enlargement of the scrotum. The disease develops after infection enters the appendage from the prostate gland or bladder. In the first hours after the onset of pain, only changes can be found in the epididymis, but not in the testicle. A Doppler ultrasound study is more informative, which allows you to identify diffuse or local intensification of blood flow in the tissues of the epididymis or testicle.

Testicular torsion

The result of torsion is compression of the spermatic cord, which leads to swelling and severe pain. The condition occurs as a result of injury, physical stress, sexual arousal, genetic predisposition. In boys infancy the risk of torsion is greatest. The second peak occurs in adolescents aged 13-18 years.

With torsion, organs on ultrasound are heterogeneous, but viable. It is also possible to have unsystematic alternation of areas with different echogenicity, which is a negative prognostic sign. In cases of subacute torsion, Doppler ultrasound examination will be required. If suspicions are confirmed, depletion, stoppage or reactive increase in blood flow is detected.

Ultrasound of the testicles makes it possible to differentiate torsion from inguinal hernias, vasculitis and idiopathic hemorrhages.

Ultrasound of the scrotum makes it possible to identify pathologies of the genital organs and diagnose urological diseases.

Ultrasound examination of the penis, testicles, and blood vessels is the best method examination, because other ways to study the scrotal area are difficult due to the peculiarities of its location.

Ultrasound of the male genital organs and blood vessels is considered the safest and most painless method of examination. In addition, the procedure is carried out very quickly and is easy to perform.

The study is carried out in a specially equipped room. To perform an ultrasound of the scrotum, the patient must take a lying or reclining position.

You definitely need to get rid of your underwear, otherwise it will be impossible to carry out the procedure.

Preparing for an ultrasound is not difficult. The device's sensor is treated with a special gel that facilitates the passage of ultrasonic waves through tissue. The same gel is applied to the skin.

The doctor moves the sensor smoothly over the area that needs to be examined. After all data has been captured and recorded, the sensor can be removed.

After the study, the patient can remove any remaining gel with a napkin or soft diaper.

The results of the ultrasound examination must be recorded in the protocol. The patient needs to wait for it and show it to his doctor.

In total, an ultrasound examination of the penis, testicles and other genital organs takes up to 15 minutes. If any pathology is detected, the procedure can last up to 30 minutes.

In this case, the specialist describes the research results in detail and, if necessary, refers to other doctors to clarify the presence of pathology.

If it is necessary to diagnose the veins in the spermatic cord, an ultrasound with Doppler is usually prescribed. Doppler ultrasound of blood vessels is prescribed when the blood supply to the genital organs is disrupted.

As a result of difficulty in the movement of blood through the vessels, erectile dysfunction of the penis can sometimes occur.

During the study, the speed and volume of blood that passes through the vessels is determined. The thickness of the vessel walls is also analyzed. All readings are carefully recorded and entered into the protocol.

By performing an ultrasound of the male genital organs, the doctor will be able to scan this area of the body and evaluate the tissues and organs.

This research method makes it possible to identify diseases and pathologies with a greater degree of accuracy than palpation.

Ultrasound has other benefits:

this method does not work negative impact on the human body;
using ultrasound, they examine the structure of the tissue;
the study will help to find out the exact sizes of the organs;
An ultrasound will evaluate the blood circulation of a given part of the body;
non-invasive method of research.

Using this ultrasound, it is not always possible to detect tumors and recognize their type: malignant, benign.

For this reason, ultrasound examination is the initial stage of examination of the male genital organs.

Using special equipment, the doctor will determine the presence/absence of pathology, document the results in a protocol and transfer them to the urologist, who will prescribe additional research and tests.

In what cases is ultrasound prescribed?

Along with examination, palpation of the testicles and penis, an ultrasound of the scrotal organs may be prescribed.

There are cases when an ultrasound appointment is necessary:

the testicles or epididymis have increased in size;
the testicles have decreased in size on two or one side;
the man suffers from infertility;
problems with penile erection;
suspicion of inflammatory processes occurring in the scrotum;
the scrotal organs were injured, resulting in a hematoma;
puberty is accelerated or delayed;
neoplasms have arisen in the scrotal organs;
when taking a semen analysis, blood was found in it;
femoral, inguinal The lymph nodes increased - there is a suspicion of malignant tumors;
the veins in the spermatic cord are dilated or an increase in their length is observed;
one or both testicles are located in abdominal cavity- cryptorchidism;
suspicion of an inguinal hernia extending into the scrotum;
to monitor the patient’s health after surgery.

For any patient, preparing for the upcoming study will not be difficult.

It is enough to carry out hygienic measures - the cleanliness of the penis and other organs of the scrotum is important. It is recommended to have loose cotton underwear.

Interpretation of ultrasound

Ultrasound examination of the scrotum is interpreted by specialists who perform this study, the results are recorded in the protocol.

Depending on the condition of the genital organs, a diagnosis or suspicion of any disease can be determined.

In some cases, to confirm the diagnosis, the patient must undergo additional examination and tests.

If an ultrasound examination does not detect testicles in the scrotum, the data indicate their descent. Sometimes the testicle is identified, but it has short spermatic cords.

This symptom indicates incomplete prolapse. If there is no grain on the device’s monitor, and the size of the testicles is slightly smaller than normal, such indicators may indicate the disease cryptorchidism.

Most often it is detected in early childhood and requires identification and treatment as early as possible.

The fact is that for sperm to form, favorable conditions must be created - 30 degrees Celsius.

When the testicles have not descended and are in the abdominal cavity, the temperature will rise to 38 degrees, which will negatively affect the quality of sperm.

In the presence of tumors, formations with irregular shapes can be distinguished on the monitor.

The structure of the formation is unclear, the surface is distorted, there is no granularity. In cases of cancer, additional tests for testosterone levels are prescribed.

Cysts or calcifications may form if age-related changes, metabolic disorders. Such formations can be detected at an early age.

When performing an ultrasound examination, a rounded formation can be detected in the tissues of the scrotum. Its contours are clear, its density differs from the tissue of the genital organ.

When diagnosing inflammatory processes, swelling of the scrotal organs is detected, general temperature the body rises, and touching the device’s sensor causes discomfort.

Often inflammation can occur as a result of injury or infection.

The doctor must correctly decipher all the data obtained from an ultrasound of the scrotum. The diagnosis and treatment prescription depend on the correct interpretation of the indicators.

The doctor who conducted the study will be able to make a preliminary diagnosis after the procedure.

Ultrasound safety

If your doctor has prescribed an ultrasound of the penis, testicles, or blood vessels, you should not refuse it. The examination may reveal various abnormalities and pathologies that require urgent treatment.

You should not be afraid of an ultrasound, as it will not cause harm to your health. Clinical researches, which were carried out many times, did not confirm the negative effects of ultrasonic waves on humans.

To examine the organs of the scrotum, a man may be prescribed an x-ray. Compared to this type of examination, ultrasound is the most gentle way to identify existing pathology.

In this case, the organs will not be exposed to radiation harmful to the penis, testicles, or other organs.

Ultrasound scanning is not only safe, but also the most informative study.

Behind short term Using the device, the doctor will be able not only to detect cysts, tumors, and other formations, but also to take measurements of organs, find out the causes of pain, and detect injuries.

There are practically no contraindications to ultrasound; preparation for the procedure is minimal. Prescribe with caution this procedure persons with mental disorders.

After all, it is unknown how the patient will behave during the study. If there allergic manifestations on the gel used for research, it is recommended to warn the doctor about this.

If a man has problems with the genital organs, then you should not neglect visiting a doctor and undergoing an ultrasound.

If pathology and deviations from the norm are detected in a timely manner, treatment will be more successful. The details of the disease will remain only between the patient and his attending physician.

Perhaps today you will not meet a person who has never undergone an ultrasound examination. Many people know what it is ultrasonic method How is such a diagnosis carried out? But not everyone understands what is written in the sonologist’s report.

The fact is that medical report Ultrasound is not a diagnosis. This is only a description of what was seen on the screen in accordance with the so-called protocol. called the template by which the doctor describes the organs and tissues being examined. This unification minimizes the likelihood of error. Here are some examples of ultrasound protocols and their samples.

It should be remembered that the protocol is not universal and varies depending on the capabilities and nature of the medical institution. For any type of study, the first thing the ultrasound diagnostic protocol form begins with is the “passport part”: the patient’s personal data and the diagnosis of the referring specialist.

Sample for abdominal organs

sizes (increase/decrease relative to the norm);
measurements of three lobes and oblique-vertical – right lobe liver;
contour (smooth / uneven);
capsule (normally not visualized);
parenchyma (structure, homogeneity);
the presence of focal compactions;
diameter of the main vessels (hepatic portal vein, inferior vena cava, hepatic veins);
nature of the vascular bed.

Gallbladder and bile ducts:

bubble size and shape;
wall thickness;
presence of formations (description if available);
diameter of the main bile duct.

sizes of all parts of the organ (head, body and tail);
contours (smooth, clear);
echostructure;
echogenicity (normal, decreased or increased);
diameter of Wirsung's duct;
Availability .

size;
splenic index;
homogeneity of echostructure.

The stomach and intestines may not appear in the ultrasound report, because these organs are not usually examined. Ultrasound can only reveal pathological symptoms, such as fluid retention or the "hollow organ" sign.

Often this form is accompanied by photographs taken during the examination. I use the information from the document, the doctor compares the data obtained with the normative ones, which allows the specialist to judge the condition of the organs

Sample protocol for breast examination

aortic diameter;
divergence of the leaflets of the aortic, mitral, tricuspid valve;
pathological divergence of the valves and opening area;
Availability pathological changes valves;
dimensions of the four chambers of the heart;
volume of blood flow in systole and diastole;
volume cardiac output(SV – stroke volume);
ejection fraction (EF);
shortening fraction (SF);
thickness and excursion of the walls of each part of the heart;
condition of the pericardial sac.

Form for vessels

For the study of blood vessels, the method allows you to evaluate the speed and characteristics and speed of blood flow in vessels and cavities (heart chambers, brain basins). The forms of this ultrasound vary greatly depending on the vessels being examined. Below we will look at a few examples.

Arteries of the upper extremities.
The specialist indicates the features of the vascular wall, the diameter of the lumen and the nature of blood flow in the following vessels of each arm:

subclavian artery;
axillary artery;
brachial artery;
radial artery;
ulnar artery.

Doppler ultrasound of the arteries of the lower extremities.
The doctor enters into the table the diameter of the lumen, the type and speed of blood flow, the resistance of the vascular wall of the following vessels of both legs:

common femoral artery;
superficial femoral;
deep femoral artery;
popliteal artery;
anterior and posterior tibial arteries;
arteries of the body of the foot.

Conclusion

Today, ultrasound diagnostics is the most common, assessing the condition of most organs and systems of the body. In order to make ultrasound results universal, and the study the same in all medical institutions, protocols, or ultrasound examination forms, were introduced separately for each localization and pathological process. Thanks to this, doctors of any specialty can easily evaluate the main indicators of ultrasound and establish the correct diagnosis.

But even such protocols are currently, unfortunately, not standardized at the state level. The materials presented in the article are only an approximate description of the signs that the doctor includes in the conclusion of the ultrasound examination. We should also not forget that the ultrasound conclusion is not a diagnosis. The final clinical conclusion and diagnosis rests with the attending physician.