Doppler analysis of scrotal vessels consumables. Ultrasound of the scrotal organs with Doppler sonography: indications and ultrasound examination of the scrotal vessels. Is it possible to have unpleasant sensations?

Doppler ultrasound uses the same ultrasound radiation as a regular exam, but the waves are emitted and received by a Doppler transducer. It emits waves that are reflected from the circulating blood, and the resulting return signal is converted into a color image. At the same time, the specialist sees the direction of blood flow, its speed, possible obstacles in its path, the structure of blood vessels and other useful information.

Doppler ultrasound is a painless and harmless method for the patient. With its help you can identify varicose veins veins of the spermatic cord and other pathologies of blood vessels in the pelvic organs. The technique is very informative and accurate; it is often a basic examination for making an accurate diagnosis.

Indications for the procedure

An appointment for an ultrasound of the scrotum with Doppler is given by a urologist to confirm the preliminary diagnosis and establish the cause of pathological changes. As a rule, Doppler sonography is prescribed if the patient has any complaints, or if the doctor suspects the development of the disease during a routine examination, and the technique is not used as a preventive measure. Ultrasound with Doppler is prescribed in the following cases:

identifying the consequences of trauma to the external genitalia;
localization and features of varicocele;
assessment of blood vessels for impotence or infertility;
testicular torsion;
increase or decrease in testicle size;
identifying dynamics after surgery;
suspicion of a tumor or hernia;
delayed or accelerated puberty;
pain in the groin area.

There are no contraindications for Doppler ultrasound; it is an absolutely safe study for all patients. No specialized training is required for the procedure.

The specialist receives the results in real time, so after completing the process, the attending physician can confirm or refute the diagnosis.

After surgery in the testicular area, regular Doppler ultrasound will be required to detect changes.

How the research is carried out

Ultrasound with Doppler is a simple research method; preparation for it consists only of the man observing basic hygiene standards. During the procedure, the patient lies on his back or side, and a gel is applied to the entire scrotal area to improve contact with the device. The specialist moves the manipulator over the area under study, and the nurse records all the necessary indicators.

The patient should prepare for the fact that the procedure will not take place in a couple of minutes. Dopplerography is a monotonous study of indicators over a certain time to identify dynamics in real time. To examine the testicles from all sides to get a complete picture, it will take at least 15 minutes, and in severe diseases requiring special attention, the process takes on average half an hour.

The indicators obtained during the study are compared with those standardized for each specific age. For various diseases of the genitourinary system, there are certain criteria by which deviations from the norm can be determined. If the patient is taking any medications, he needs to inform the doctor in advance so that he takes into account possible changes in indicators.

What information does Doppler ultrasound provide?

The examination is aimed not only at studying the condition of the vessels, it gives a general picture of the disease, since conventional ultrasound waves are used. In this case, not only the anomalies themselves are identified, but also the reasons for their occurrence. Using Doppler ultrasound, a specialist can obtain the following data:

the number of testicles in the scrotum (there may not be any at all, or there may be more than 2);
the position of the testicles (abnormalities can occur, for example, testicular torsion or failure of one testicle to descend into the scrotum);
the presence of fluid of different nature between the membranes of the testicle and its quantity;
shape, structure and size of testicles;
appendage size;
condition of the walls of blood vessels;
circulatory condition.

Despite all the information content of the method, Doppler ultrasound does not always make it possible to make an absolutely accurate diagnosis. Examination of blood vessels does not always provide a complete picture of the blood supply to the testicles, and the testicle may not be displayed if it has not descended into the scrotum, but is located in abdominal cavity. And yet, Doppler sonography is one of the main methods of diagnosing disorders of the male reproductive system.

Advantages and disadvantages of the technique

In comparison with other diagnostic measures, Doppler ultrasound looks in a much more favorable light. Its advantage is that it is absolutely safe because it is non-invasive, that is, there is no need to damage the integrity skin.

Contact of the skin of the external genitalia with the device’s manipulator does not impair fertility or reduce libido. Also, unlike radiography, there is no radiation exposure to the patient.

Another advantage is that it is not necessary to inject the patient with a contrast agent to get a clear picture.

Ultrasound with Doppler can be prescribed at any age, even for children there is no danger in the procedure. The relatively low cost of Doppler ultrasound also speaks in favor of this technique. The only drawback of the method is the low information content in some exceptional cases.

What sensations to expect?

The ultrasound machine manipulator glides only along the outer surface of the scrotum, without damaging the integrity of the skin. For this reason, no pain can occur. The only exceptions are those cases when the patient has inflammation accompanying the disease.

To avoid significant discomfort, a man needs to warn the specialist in advance so that he performs the manipulations carefully.

The only unpleasant sensation that may occur during Doppler ultrasound is the feeling of coolness from the gel. The skin in the scrotum area is very sensitive, so the temperature difference is clearly felt. However, this sensation cannot be called painful; it is not difficult to endure.

Before the Doppler procedure, you must wear underwear that can be easily washed. It is not always possible to completely remove the gel from the treated area, so traces may remain.

Cost of the procedure

The cost of Dopplerography depends, firstly, on the region and city of the procedure, and secondly, on the clinic’s markups - the more prestigious it is, the higher the price. In public hospitals, this procedure is also carried out, but it is very difficult to get a free voucher for it, and the queue must be filled several months in advance. Therefore, most often patients choose a paid, but quick and comfortable examination.

The price of the procedure can range from 600 to 3000 rubles. Some clinics provide home-based services, in which case another 1000-2000 rubles are added to the total cost. To save money, you can choose a clinic that has a promotion for this examination, but this does not happen so often.

Ultrasound of the scrotum– a diagnostic study that allows you to evaluate the size, structure of the testicles and appendages, the structure of the scrotal wall, the volume of fluid produced by the testicles and prostate gland. The technique is indicated for the diagnosis of infertility, erectile dysfunction, disorders of sexual development and testicular tumors. There are two examination options: ultrasound of the scrotum (isolated) and ultrasound of the scrotum with Doppler examination of blood vessels. The cost of the diagnostic procedure depends on the scope of the ultrasound examination.

Preparation

Ultrasound of the scrotum is performed without special preparation. Before the study, you need to carry out daily hygiene procedures. Fear, fear, pain and stress can cause the testicles to be retracted into the inguinal canal, so the child needs to be emotionally prepared for the upcoming manipulations: talk about their safety and importance for health. If there is pain in the scrotum, you should notify the doctor about this, then before scanning he will apply surface anesthesia.

What does it show

Ultrasound of the scrotal organs visualizes the testicles and epididymis, their number, size, structure and contours; the volume of free fluid is estimated; the presence of neoplasms and traumatic lesions is revealed. With a comprehensive ultrasound examination of the scrotum and vessels, along with the characteristics listed above, the state of local blood flow, the integrity and patency of superficial and deep vessels are studied, aneurysms, blood clots, emboli, thromboemboli and atherosclerotic plaques are diagnosed.

Normally, on an ultrasound image, the testicles appear as paired round formations with a smooth surface. They have moderate echogenicity with a fine-grained structure and consist of several layers that differ in density and thickness. The epididymis are wedge-shaped structures, structurally similar to the testicles. A certain amount of homogeneous liquid may be detected. Using ultrasound diagnostics, the following pathologies are detected:

Cryptorchidism. Ultrasound diagnostic devices make it possible to visualize testicles with a diameter of more than 10 mm. With cryptorchidism, they can be found in the inguinal canal. In every tenth patient with cryptorchidism, one testicle remains in the abdominal cavity and is not detected by ultrasound. Doppler ultrasound confirms insufficient or absent testicular blood flow.
Puberty disorders. Ultrasound is used to diagnose delayed or early puberty. During puberty, the echo density of the testicles increases, becoming like that of adults (in children it is lower). This usually happens by the age of 15-17 years. Another sign of puberty is the testicular mediastinum, which appears as a band of high echogenicity in the sagittal plane.
Testicular neoplasms. The heterogeneity of the echostructure of the glands is determined. Tumors are represented by areas of altered echogenicity: lymphoma, seminoma – decreased; chorionepitheliomas, embryonal carcinomas, teratomas – increased. In case of decay, internal cyst or hemorrhage, fluid is visualized within the neoplasia.
Testicular calculi. Formed in Klinefelter syndrome, cryptorchidism, after chemotherapy. On the monitor of an ultrasound machine, calcifications are represented by high-density echo-positive inclusions.
Orchitis. The inflammatory process is triggered by infection or injury. In the ultrasound picture, the size of the testicle is significantly increased, homogeneous internal structure preserved, but with edema a homogeneous decrease in echogenicity is characteristic. According to Doppler examination, an increase in blood flow is detected, and in the chronic form of orchitis - a decrease.
Epididymitis. Acute inflammatory processes in the epididymis occur during infection. On the first day, the tissue of the testicles is not changed, only the size of the epididymis increases. Later, signs of orchitis are diagnosed. Doppler ultrasound confirms diffuse and local increased blood supply in the testicle and epididymis.
Varicocele. Varicose veins of the spermatic cord develop with scars, tumors and abnormalities in the location of blood vessels. Based on the results of Doppler ultrasound, changes in the structure and tone of the veins, uneven blood flow with congestion and pathological discharge of blood are diagnosed.
Testicular torsion. Torsion occurs after injuries, against the background of stress and sexual arousal. The tissues of the gonads are heterogeneous, with areas of different echogenicity randomly alternating. Dopplerographic signs are a sharp depletion, absence or reactive acceleration of blood flow in the testicles.

An ultrasound of the scrotum is performed as part of a comprehensive examination of the patient. The results are interpreted taking into account the data from the patient's interview, examination and laboratory tests. The suspected diagnosis is confirmed after receiving complete information about the condition of the scrotal organs.

Advantages

Scanning the scrotum using ultrasound waves does not have a negative effect on the body and does not affect erectile and reproductive function. At the same time, the study provides up-to-date information about the structure and functioning of the epididymis and testicles, allows diagnosing diseases in the early preclinical stages, and monitoring the effectiveness of treatment. Despite the safety and accessibility of ultrasound, the information content of its data is limited. For example, to clarify the nature of the neoplasm, additional MRI, biopsy and histological examination of tissue are required.

Preparation

What does it show

Cryptorchidism. Ultrasound diagnostic devices make it possible to visualize testicles with a diameter of more than 10 mm. With cryptorchidism, they can be found in the inguinal canal. In every tenth patient with cryptorchidism, one testicle remains in the abdominal cavity and is not detected by ultrasound. Doppler ultrasound confirms insufficient or absent testicular blood flow.
Puberty disorders. Ultrasound is used to diagnose delayed or early puberty. During puberty, the echo density of the testicles increases, becoming like that of adults (in children it is lower). This usually happens by the age of 15-17 years. Another sign of puberty is the testicular mediastinum, which appears as a band of high echogenicity in the sagittal plane.
Testicular neoplasms. The heterogeneity of the echostructure of the glands is determined. Tumors are represented by areas of altered echogenicity: lymphoma, seminoma – decreased; chorionepitheliomas, embryonal carcinomas, teratomas – increased. In case of decay, internal cyst or hemorrhage, fluid is visualized within the neoplasia.
Testicular calculi. Formed in Klinefelter syndrome, cryptorchidism, after chemotherapy. On the monitor of an ultrasound machine, calcifications are represented by high-density echo-positive inclusions.
Orchitis. The inflammatory process is triggered by infection or injury. In the ultrasound picture, the size of the testicle is significantly increased, the homogeneous internal structure is preserved, but swelling is characterized by a homogeneous decrease in echogenicity. According to Doppler examination, an increase in blood flow is detected, and in the chronic form of orchitis - a decrease.
Epididymitis. Acute inflammatory processes in the epididymis occur during infection. On the first day, the tissue of the testicles is not changed, only the size of the epididymis increases. Later, signs of orchitis are diagnosed. Doppler ultrasound confirms diffuse and local increased blood supply in the testicle and epididymis.
Varicocele. Varicose veins of the spermatic cord develop with scars, tumors and abnormalities in the location of blood vessels. Based on the results of Doppler ultrasound, changes in the structure and tone of the veins, uneven blood flow with congestion and pathological discharge of blood are diagnosed.
Testicular torsion. Torsion occurs after injuries, against the background of stress and sexual arousal. The tissues of the gonads are heterogeneous, with areas of different echogenicity randomly alternating. Dopplerographic signs are a sharp depletion, absence or reactive acceleration of blood flow in the testicles.

Advantages

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Ultrasound examinations of the male genital organs make it possible to detect any deviations in their structure from the norm. Based on the results, the diagnosis is confirmed or established, and the most effective direction of therapy is selected. Dopplerography of the vessels of the penis and scrotum is necessary to assess the state of the blood supply system to these organs, because normal blood flow is the basis for the healthy functioning of all systems of the human body, including the reproductive one.

When is a test ordered?

The basis for conducting an ultrasound of the genital organs is the specialist’s suspicion of the presence of organic changes in the structure of these organs, leading to the manifestation of functional disorders (enlarged inguinal lymph nodes, severe deviations in spermogram, pain in the groin, injuries). But sometimes, along with ultrasound, Dopplerography of the penis is also prescribed, and, if necessary, the scrotum.

Reasons for supplementing conventional ultrasound with Doppler ultrasound are suspicions of a violation of the blood supply to the penis or a change in the structure of its important blood vessels, which occurs in the following conditions:

The formation of fibrous plaques that accompanies the course of Peyronie's disease.
Injury, dislocation, fracture of the penis or bruise.
Erectile dysfunction arising from vascular pathologies.
Change of structure urethra.
Palpation detection of a neoplasm in the structure of the organ. The study is necessary to determine the activity of its blood supply and the prospects for an increase in size.
The presence of a foreign body inside the urethra.
Formation of plaques, blood clots, fibrous nodes with partial or complete blockage of the lumen of important vessels.

The genital organs have a rather complex blood supply system, therefore, to determine the pathological processes developing in the scrotum, an ultrasound scan of this organ may be required.

The study is prescribed if the following indications exist:

The appearance of swelling in the scrotum area.
Bruised testicles.
Systemic diseases of the circulatory system, such as atherosclerosis or varicose veins.
Neoplasms.
Suspicion of a congenital anomaly of the scrotum.
Exposure to radioactive radiation.
Suspicion of twisting of the spermatic cords.
Cystic or varicose formations in the scrotum.