Color Doppler ultrasonography as a routine clinical examination in male infertility

Authors: SAKAMOTO, HIDEO; SAITO, KATSUYUKI; SHICHIZYO, TAKESHI; ISHIKAWA, KIMIYASU; IGARASHI, ATUSHI; YOSHIDA, HIDEKI

Source: International Journal of Urology, Volume 13, Number 8, August 2006 , pp. 1073-1078(6)

Publisher: Wiley-Blackwell

Abstract:

Aim:

We assessed the value of scrotal color Doppler ultrasonography as a routine examination in infertile men. Methods:

Color Doppler ultrasonography was performed in 545 infertile men with a mean age of 35.8 years to detect intrascrotal abnormalities. Findings were compared with those of physical examination. Results:

Intrascrotal abnormalities were detected by ultrasonography in 65.3% of patients. Of 374 abnormalities, 58.3% were undetected by physical examination. Left varicocele was found in 313 patients (57.4%); testicular microlithiasis in 30 (5.5%); epididymal cyst in 21 (3.9%); right varicocele in 4 (0.8%); and testicular cysts in 3 (0.6%). One occurrence each (0.2%) was found for testicular tumor, intrascrotal hemangioma, and hydrocele of the spermatic cord. Compared to ultrasonography, sensitivity in detecting left varicocele by physical examination was 58.4%; specificity, 79.3%; accuracy, 67.3%; and positive predictive value, 79.3%. Venous diameters in the pampiniform plexus were 3 mm or more in 61.5% of 130 subclinical left varicoceles. Of 30 patients with testicular microlithiasis, 14 had varicocele, 2 had epididymal cyst,s 3 had a history of mumps orchitis, 1 had retractile testis, and 1 had a history of orchiectomy for contralateral testicular tumor. Conclusions:

The routine Color Doppler ultrasonography is valuable for diagnosing scrotal abnormalities in infertile men, frequently detecting non-palpable lesions.

Keywords: infertility; testicular microlithiasis; testicular tumor; ultrasonography; varicocele

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1442-2042.2006.01499.x

Affiliations: 1: Department of Urology, Showa University School of Medicine, Tokyo, Japan

Publication date: 2006-08-01

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