Sonographic spectrum of scrotal abnormalities in infertile men

Abstract Purpose. To use sonography to detect scrotal abnormalities in infertile men. Material and Methods. Two hundred thirty‐four infertile men, including 176 oligospermic (sperm count < 10 × 10 6 /ml), 58 azoospermic, and 150 normospermic men (control group) were evaluated prospectively for the presence of intra‐ and extratesticular abnormalities using high‐frequency transducers and color Doppler imaging. Medical and surgical history, testicular volume, semen parameters, and hormonal levels were recorded. Results. A statistically significant increase in the prevalence of abnormal scrotal findings detected with sonography was observed in the study group compared with controls. These included variocele in 35.5% versus 16% ( p < 0.01), hydrocele in 16.7% versus 8.7% ( p < 0.05), testicular microlithiasis in 9.8% versus 2% ( p < 0.01), epididymal enlargement in 9% versus 2.6% ( p < 0.05), and epididymal cyst in 7.7% versus 2% ( p < 0.05). Testicular tumor was not seen in either group. A statistically significant decrease in testicular volume, sperm concentration, normal morphology, and forward motility of the sperm was noted in the study group compared with controls ( p < 0.01). Conclusion. The various intra‐ and extratesticular abnormalities were demonstrated in infertile men. Sonography should be used routinely in the work‐up of male infertility. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007