CLINICAL RELEVANCE OF SCROTAL AND TRANSRECTAL ULTRASONOGRAPHY IN ANDROLOGICAL PATIENTS

Sonography of the scrotal contents, the prostate and the seminal vesic les has become an important diagnostic tool in andrology. In a prospec tive study of 1048 consecutive patients attending the Institute of Rep roductive Medicine only 520 patients (49.6%) did not show sonographic abnormalities of the scrotal contents. The leading abnormality in the other 528 patients (50.4%) was a varicocele (194 patients, 18.5%), inc reased size of the epididymis (147 patients, 14.0%), epididymal cyst o r spermatocele (55 patients, 5.2%), hydrocele (104 patients, 9.9%), te sticular non-homogeneity (92 patients, 8.8%), testicular hypoechogenic ity (132 patients, 12.6%), testicular cyst (12 patients, 1.1%) and tes ticular tumour (5 patients, 0.5%) (sum of percentages exceeds 50.4% be cause of multiple abnormalities in individual patients). In addition t o the high incidence of pathological findings, the significantly highe r incidence of testicular tumours compared to the general population a nd the early detection by ultrasonography render scrotal sonography a diagnostic procedure with high clinical relevance. Transrectal sonogra phy of the prostate and seminal vesicles is valuable for detection of chronic urogenital infections or functional abnormalities of the semin al vesicles in infertile patients. In hypogonadal patients, transrecta l examination of the prostate should be performed longitudinally to mo nitor the biological efficacy of testosterone treatment by measuring p rostate growth and, in combination with palpation and PSA measurements , to screen for prostate cancer.