A 10-Year review of ultrasonographic findings of scrotal diseases in Ibadan, South Western, Nigeria

Introduction: Despite the importance of a thorough clinical evaluation, ultrasonography has emerged as the mainstay of imaging of the scrotum and its contents. Differentiation of testicular lesions and that of adjacent scrotum and content is usually difficult clinically. Scrotal ultrasound (SUSS) is highly sensitive in the detection of intrascrotal abnormalities and in differentiating testicular from paratesticular lesions. SUSS accurately determines the location and nature of palpable lesions and reveals nonpalpable scrotal masses. The aim of this study is to report the various indications for SUSS in this setting and to describe the sonographic findings in these patients. Materials and Methods: A retrospective and descriptive study carried out to evaluate scrotal ultrasound scans performed on 442 patients referred for various clinical indications from the clinics and units of the University College Hospital, to the Radiology department of the same hospital which serves as referral center in Ibadan, and the South-Western Nigeria; over a 10 year period from January 2006 to December 2015, a tertiary health Institution. Results: The mean age of the study population was 36.13 years ± standard deviation 15.88 years. Most of the patients (57.1%) were within the age group of 30 and 49 years. The leading clinical indication for ultrasound referral was infertility/infertility related issues in 56.1% of the total patients. Testicular masses were clinically detected and required SUSS for confirmation in 4.5% of the study population. On USS, the average testicular volume in adults with normal study was 16.38 cm3 and 15.99 cm3 on the right and left side, respectively. The most common USS findings were varicocele (29.4%), this was bilateral in more than half of the cases. Hydrocele was the second most common finding in 18.78% and often bilateral. Testicular masses were seen in 11.1% and were cystic in nature in more than half of the study population. Conclusion: Infertility/infertility related diagnosis were the most frequent indications for testicular ultrasound in adults in our environment. We recommend SUSS as a routine investigation in suspected scrotal/testicular pathologies.