A testicular ultrasound (sonogram) is a test that uses reflected sound waves to show a picture of the testicles and scrotum. The test can show the long, tightly coiled tube that lies behind each testicle and collects sperm (epididymis). And it can show the tube (vas deferens) that connects the testicles to the prostate gland. The ultrasound does not use X-rays or other types of radiation.
A small handheld device called a transducer is passed back and forth over the scrotum. The device sends the sound waves to the computer, which turns them into a picture. This picture is shown on a video screen. The picture produced by ultrasound is called a sonogram, echogram, or scan. Pictures or videos of the ultrasound images may be saved.
Why It Is Done
Testicular ultrasound is done to:
- Check a mass or pain in the testicles.
- Find or check on an infection or swelling of the testicles or epididymis.
- Check for twisting of the spermatic cord. This problem cuts off blood supply to the testicles (testicular torsion).
- Check to see if testicular cancer has come back.
- Find an undescended testicle.
- Check for fluid in the scrotum (hydrocele), fluid in the epididymis (spermatocele), blood in the scrotum (hematocele), or pus in the scrotum (pyocele).
- Guide a biopsy needle for a testicular biopsy. This may be done when testing for infertility.
- Check an injury to the genital area.
How To Prepare
You don't need to do anything to prepare for a testicular ultrasound.
If you are having a biopsy or another test during the ultrasound, you may need to sign a consent form.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form( What is a PDF document? ).
How It Is Done
A testicular ultrasound is usually done by an ultrasound technologist. It is done at a doctor's office or hospital.
Before the test, you will need to take off all your clothes from the waist down. You will put on a gown. You will be asked to lie on your back on a padded table. Folded towels will be used to cover the penis and lift the scrotum. A gel (such as K-Y Jelly) will be spread on your scrotum. This is used for the transducer, which is pressed against your skin and moved across your scrotum many times.
You will need to lie very still during the ultrasound scan. You may be asked to take a breath and hold it for several seconds during the scan. The test takes about 20 minutes.
When the test is finished, the gel is removed from your skin. You may be asked to wait until the radiologist has reviewed the test. He or she may want to do more ultrasound views.
How It Feels
The gel may feel cold when it is put on your scrotum. Or it may be warmed to body temperature first. You will feel light pressure from the transducer as it passes over your scrotum. If the test is being done to find out how bad damage is from a recent injury or to find out what is causing pain in the testicles, the slight pressure of the transducer may be a bit painful. You will not hear the sound waves.
If a biopsy is done during the ultrasound, you may have slight discomfort when the sample is taken.
The testicles are normal in shape and size. They are in the normal position.
There is no sign of a noncancerous (benign) or cancerous (malignant) lump in the testicles.
There is no sign of infection or swelling of the testicles or epididymitis.
There is no twisting of the spermatic cord. This twisting (testicular torsion) cuts off blood supply to the testicles.
There is no sign of fluid in the scrotum (hydrocele), blood in the scrotum (hematocele), fluid in the epididymis (spermatocele), or pus in the scrotum (pyocele).
There is a lump in the testicle or there are signs of testicular cancer.
There are signs of infection or swelling of the testicles or epididymis.
The spermatic cord is twisted. This problem cuts off blood supply to the testicles (testicular torsion).
No testicle or only one testicle is present in the scrotal sac.
Fluid (hydrocele), blood (hematocele), or pus (pyocele) is present in the scrotum or fluid is present in the epididymis (spermatocele).
There is a hernia in the scrotum.
What Affects the Test
You may not be able to have the test, or the results may not be helpful, if you:
- Can't stay still during the test.
- Have an open sore or wound in the area that needs to be viewed.
What To Think About
- Testicular ultrasound is usually done to check a mass or pain in the testicles for cancer. Young men with a testicular mass or pain should be checked right away by a doctor. Testicular cancer is the most common cancer in young men.
- With this test, your doctor can usually tell the difference between a fluid-filled cyst, a solid lump, or another type of mass.
- A fluid-filled mass with a shape that's the same on both sides and that does not have tiny pieces floating in it is likely to be a cyst or a hydrocele.
- A mass that does not have fluid, has fluid with tiny floating pieces (atypical cyst), or is larger than expected needs more testing. Often a follow-up ultrasound is done in 6 to 8 weeks. This is to allow time for the mass to go away on its own.
- If a solid lump or an atypical cyst is present and a testicular ultrasound can't show if it is cancer, a biopsy may be done.
Other Works Consulted
- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.