Ultrasound scanning is performed by a specifically trained Sonographer, who uses the ultrasound machine to obtain images on a screen, usually in black and white. These images are stored electronically and can be printed out for viewing, but most of the information is gained by an experienced sonographer during the actual examination. A special gel is applied to the scrotum, to form an acoustic interface with the ultrasound probe. The gel may be cold but is otherwise harmless. Mild pressure of the probe during the examination can be uncomfortable, if the area being examined is tender. You will be required to undress and change into a light gown before the procedure.
Testicular Ultrasound may be requested in the setting of a painless lump in the scrotum or testicle, to exclude a cyst or tumour. A scrotal or testicular swelling should always be taken seriously. A painful testicle may be due to infection or inflammation in part of the testis known as the epididymis. This is called epididymitis or epididymo-orchitis and may be acquired via the bloodstream or as a sexually-transmitted infection. It may cause urinary frequency (having to pass urine very often) or burning or stinging when passing urine, called dysuria. Testicular torsion, literally a twisting of the testis on its own cord, is a very serious problem causing pain and tenderness in the testicle of relatively sudden onset, often accompanied by nausea or vomiting. Torsion of the testis is an emergency requiring an operation to “un-twist” the testicle, the time to surgery is critical because the testis may die due to lack of blood supply, within a few hours. Usually if the Emergency Physician or Urologist thinks that testicular torsion is quite likely, the patient would go directly to the operating theatre as an emergency, rather than performing an Ultrasound Scan, which may delay time-critical treatment.
The Testicular Ultrasound Scan aims to determine whether a swelling is solid or fluid-filled - a cyst. The scan appearances may be suggestive of a cause for the swelling, but sometimes the ultrasound is used to guide a biopsy of a swelling or lump: a fine needle is inserted and a small amount of fluid or tissue removed for analysis. In painful conditions of the testicle, the main aim is to determine whether the blood supply to the testis is normal. Increased blood flow is suggestive of epididymitis, while decreased blood flow would be much more serious and may indicate a testicular torsion.
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