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General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
What are the indications to perform a scrotal ultrasound?In ambiguous cases – adenomatoid tumours, non-resolving epididymo-orchitis can mimic a tumour that has bledWhen there is a suspicion of malignancy – new irregular lump
The Infertile Male
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Thoraya Ammar, C. Jason Wilkins, Dean C.Y. Huang, Paul S. Sidhu
The European Association of Urology deem scrotal ultrasound a mandatory examination in the investigation of the infertile male. Scrotal ultrasound is excellent for the initial evaluation of the scrotum and can directly demonstrate abnormalities within the testis and the peritesticular structures.
Surgical Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Only arrange scrotal ultrasound if the diagnosis is in doubt or the history is prolonged, to assess blood supply and to look for an alternative diagnosis. This must never delay urgent urological assessment.
Diagnostics of CFTR-negative patients with congenital bilateral absence of vas deferens: which mutations are of most interest?
Published in Expert Review of Molecular Diagnostics, 2020
Alberto Ferlin, Liborio Stuppia
Congenital absence of vas deferens could also be unilateral (CUAVD) as a consequence of mild CFTR mutation. This condition is rare, with a 1:100 proportion with CBAVD. In CUAVD cases the clinical suspicion could be extremely difficult. In fact, these cases might present with mild oligozoospermia and even normozoospermia (if the contralateral testis is normally functioning), and seminal volume and pH can be unaffected [1]. The only way to have a correct diagnosis is performing scrotal ultrasound, but it is evident that a large number of patients remain undiagnosed. A proportion of CUAVD patients has an ipsilateral absence of the kidney, but this condition is not related to CFTR.
Isolated penile corporeal cavernosal injury accompanying pelvic fracture after motor vehicle accident
Published in Baylor University Medical Center Proceedings, 2022
Mohamed Elsaqa, Ryan Morris, Lester Wang, Marawan M. El Tayeb
Computed tomography (CT) of the pelvis revealed hematoma at the left bladder base and marked scrotal swelling. Scrotal ultrasound showed normal testes with scrotal wall hematoma. Complementary CT cystogram revealed an intact bladder with left pelvic wall hematoma with the greatest density along the left base of the penis and inferior aspect of the left pubic ramus. Left corporeal cavernosal injury was suspected based on the CT scan (Figure 1b). Conservative management of the suspected corporeal injury was the chosen approach due to the associated multiple injuries and the patient’s biplanar fixation of pelvis fractures.
Is follow-up ultrasound necessary after acute epididymitis? A retrospective analysis from a large university hospital
Published in Scandinavian Journal of Urology, 2018
J. Capet, J. Sønsksen, R. Bisbjerg, M. Fode
Acute epididymitis usually presents with scrotal swelling, tenderness and pain [1]. Meanwhile, these symptoms can also arise from other scrotal pathologies, including testicular torsion, trauma, inguinal hernia and testicular cancer and it is essential to distinguish between these conditions. In the acute setting, the diagnosis is usually made based on the clinical appearance and simple laboratory tests. In addition, the use of scrotal ultrasound (US) may aid in the diagnosis. However, this modality is not always available due to factors such as time constraints, lack of equipment and lack of sufficiently trained personal. The matter is further complicated by the fact that US findings may be difficult to interpret in cases with acute inflammation. In accordance with this, the latest European Association of Urology Guidelines on the subject are somewhat unclear and the only clear indication for US is in cases where complications are suspected or if treatment of epididymitis with antibiotics has failed [2]. However, although some studies comparing acute and delayed scrotal US exist [3,4], no studies to date have specifically addressed the value of delayed scrotal US in seemingly uncomplicated epididymitis, not assessed by initial US. At Herlev and Gentofte Hospital, patients who are diagnosed with epididymitis at the emergency department generally only undergo scrotal US in the acute setting when it is deemed necessary based on the clinical assessment. Due to the uncertainties in this approach, those who are clinically diagnosed and simply discharged with antibiotics without initial scrotal US are offered a follow-up appointment with scrotal US after ∼3 weeks. The objective of this study is to investigate the added value of these routine US investigations by assessing whether there were cases of serious underlying scrotal pathology.