Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissues. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum. Ultrasound is safe, noninvasive, and does not use ionizing radiation.

This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

What is Ultrasound Imaging of the Scrotum?

Ultrasound imaging of the scrotum provides pictures of a male’s testicles and the surrounding tissues.

Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.

Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

What are some common uses of the procedure?

Ultrasound imaging of the scrotum is the primary imaging method used to evaluate disorders of the testicles, epididymis (a tube immediately next to a testis that collects sperm made by the testicle) and scrotum.

This study is typically used to:

  • determine whether a mass in the scrotum felt by the patient or doctor is cystic or solid and its location.
  • diagnose results of trauma to the scrotal area.
  • diagnose causes of testicular pain or swelling such as inflammation or torsion.
  • evaluate the cause of infertility such as varicocele.
  • look for the location of undescended testis.

A sudden onset of pain in the scrotum should be taken very seriously. The most common cause of scrotal pain is epididymitis, an inflammation of the epididymis. It is treatable with antibiotics. If left untreated, this condition can lead to an abscess or loss of blood flow to the testicles.

Ultrasound can often detect an absent or undescended testicle as well. It is estimated that approximately three percent of full-term baby boys have an undescended testicle. The testicle normally migrates from the abdomen down a short passage called the inguinal canal and then into the usual position in the scrotal sac before birth. If not present in the scrotal sac, the testicle may have stopped in the inguinal region, in which case the ultrasound examination will often see it. If the testicle has not left the abdominal cavity, it may not be seen by sonography. If a testicle is not detected, a urologist may be consulted in order to decide whether additional imaging such as an MRI is needed to determine its location. If the testicle is found to be in the inguinal region, it may be moved into the scrotum. If left in the abdomen too long, the testicle may become cancerous and may need to be removed.

Ultrasound can identify testicular torsion, the twisting of the spermatic cord that contains the vessels that supply blood to the testicle. Testicular torsion is caused by abnormally loose attachments of tissues that are formed during fetal development. Torsion commonly appears during adolescence, and less often in the neonatal period, and is very painful. Torsion requires immediate surgery to avoid permanent damage to the testicle.

Ultrasound also can be used to locate and evaluate masses (lumps or tumors) in the testicle or elsewhere in the scrotum. Collections of fluid and abnormalities of the blood vessels may appear as masses and can be assessed by ultrasound. Masses both outside and within the testicles may be benign or malignant and should be evaluated as soon as they are detected.

How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.

You may be asked to wear a gown during the procedure.

No other preparation is required.

If your son is undergoing the examination, explain the procedure to him. In most cases, you will be able to accompany him into the examination room for support and reassurance.