Doppler ultrasonography of the vessels of the scrotum - consumables. The procedure of ultrasound of the scrotum and penis with Doppler and how much does the study cost

For the study of organs located in the scrotum, an ultrasound scan of the testicular vessels is prescribed. It is a safe method that eliminates radiation and invasiveness. This procedure assesses the speed and direction of blood flow, the presence of blood clots, pathologies, the state of the vascular lumen and refers to an additional method for examining the male genital organ.

Method characteristic

Ultrasound of the scrotal organs with Doppler ultrasound is based on the Doppler principle. With the help of this study, the sound wave is measured, the frequency of the signal is determined and mathematical processing is performed. Doppler ultrasound assesses the state of the blood vessels, determines the presence of pathologies of organs located in the scrotum, what capacity the vessels have. It is not uncommon to measure blood flow while erect to obtain a complete picture.

An ultrasound machine, which is equipped with a Doppler, has the following types:

• CDC is based on color mapping of blood flow. The most commonly used colors are red and blue.
• ED allows you to assess the picture of what is happening due to color shades, their brightness, intensity.
• The ID evaluates the blood flow velocity using an acoustic signal.

When shown

Doppler ultrasound is used if there is a suspicion of a benign or malignant formation. However, there are other indications for research: varicocele, testicular torsion, injuries resulting from trauma or blows. With these pathologies, ultrasound not only assesses the blood flow, but also helps to identify the reasons that provoked them.

Often, a child is examined in the presence of an acute stage of the disease. It is the only way that provides maximum information and allows you to determine the therapeutic regimen.

• pain in the scrotum, swelling, which indicate the presence of an inflammatory process;
• an enlarged scrotum, which indicates the presence of an infectious disease, hernia, hydrocele;
• tumor process, palpable and visible with ordinary eyes;
• infertility;
• obstruction of the connecting canal;
• injuries;
• undescended testicle.

If during the ultrasound scan the doctor does not receive the necessary information, then the patient may be assigned an additional examination, for example, a color examination with a Doppler

What shows

Many men are interested in the question of what an ultrasound scan of the scrotum shows. When conducting this survey, the following data are obtained:

• how many testicles are in the scrotum;
• how the testicles are located;
• whether there is liquid in the shells and what is its amount;
• the shape of the testicles;
• echo structure of the investigated area;
• the size of the appendages;
• blood flow condition.

In a healthy person, the testicles should be in the scrotum. However, the following phenomena also occur: one or two testicles are not lowered into the scrotum, the testicle is located near the base of the genital organ, on the femoral part, the pubis, testicular torsion, which is characterized by the location of the upper pole in the lower part, the location of the epididymis in front of the testicle. Its normal location is behind the organ.

Carrying out the procedure

For ultrasound diagnostics, no special preparatory measures are required. Research can be conducted at any time. Preparation for an ultrasound scan states that three days before the diagnosis, it is necessary to exclude the use of any alcoholic beverages, a day - coffee, strong tea, medicines that have an effect on blood pressure. In addition, it is important to carry out hygienic treatment of the penis, do not take liquid for 3 hours. It is recommended to visit the toilet half an hour before the procedure.

During the procedure, the doctor guides the area under investigation with an ultrasound probe

This procedure is completely painless and takes 20 minutes. During the study, the patient lies on the couch on his back or side, freeing the lower body from clothing. It may also be necessary to change the position of the body, the examination can be carried out while standing. A gel is applied to the research area to conduct electromagnetic waves. During an ultrasound scan, the following pelvic organs are diagnosed:

• testicles;
• prostate;
• seminal vesicles;
• penis;
• scrotum;
• the vas deferens;
• prostate gland.

Norm

Deciphering an ultrasound scan primarily shows the shape of the testicles. In a healthy man, the testicles are round or oval in shape. The testicles can be presented with a changed shape, which is elongated, unilaterally enlarged. If the ultrasound norm is rejected, then this may be a sign of an inflammatory process, cancer, or injury. Indicators of contours and sizes are also important.

The increased size, the changed contour can speak of oncology, torsion, orchitis. A decrease in size indicates atrophy, hypoplasia, and hypotrophy. Violation of the echostructure is a sign of cystosis, abscess, hematomas. These pathologies are characterized by heterogeneity of the echostructure. Indicators of a man's norm are:

• testicles from 3 to 5 cm long, from 2 to 3 cm wide, with a homogeneous echo structure, without the presence of formations, with smooth and clear edges;
• appendages - the size of the head is not less than 10 mm, the tail and body should not be visible, without the presence of formations, with a homogeneous echo structure;
• scrotum - thickness no more than 8 mm, without the presence of formations, with a homogeneous echo structure;
• free liquid should be present in a volume of 1 to 2 mm, with a homogeneous echo structure.

Diagnosis of pathology is carried out both in childhood and in adulthood

Doppler also allows you to analyze the following indicators:

• structures of cavernous bodies, which should have a diameter of 3 to 5 mm with a homogeneous echo structure, without the presence of inclusions;
• the beginning of an erection should have a top speed of 35 cm in sec. / 8 cm in sec. Young patients may have readings of 100 cm in s. / 20 cm in s. In this case, an increase in the diameter of the corpus cavernosum occurs up to 10 mm;
• in the rigid phase, a decrease in speeds occurs. However, the peak velocity should not be lower than 30 cm / s. A lower number indicates erectile dysfunction;
• the difference in the size of the corpus cavernosum from erection to rest should be above 60%;
• the resistance index rate should be more than 0.85; pulsation - 4.

Frequent pathologies

Most often, the following pathologies are diagnosed with the help of USDG. Testicular torsion, which refers to injuries resulting from overexertion of the abdominal muscles. This pathology is accompanied by swelling, painful sensations, often found in young boys.

Spermatocele is characterized by an enlargement of the testicles, which causes discomfort, pressure that increases during walking, any change in position. This condition can cause a cyst and lead to its rupture. Ultrasound of the vessels of the scrotum reveals disturbed blood flow, shows narrowed vessels, injuries. Thereby contributing to the early initiation of therapy.

Ultrasound of the scrotum allows you to get information about the condition of the testicles and surrounding tissues.

An ultrasound machine converts high-frequency sound waves to produce black and white images. Normal and abnormal tissues transmit different types of signals and are displayed differently on a video monitor. This allows you to analyze the benignity and malignancy of the formations, as well as their density, boundaries and sizes.

Ultrasound of the scrotal organs with Doppler ultrasonography of the testicular vessels and spermatic cord

During the study, scrotal tissues are scanned in detail, and testicular vessels and spermatic cords are assessed using a Doppler. Doppler shows the speed and completeness of movement inside the vessels and cords. Blockage or critical narrowing may be seen.

Conducted by an adrologist, urologist Konstantin Anatolyevich Menshchikov.

Ultrasound of the scrotum, prostate and seminal vesicles

with conclusion

Price 2000 rubles

Ultrasound of the scrotal organs with Doppler ultrasonography of the testicular vessels and spermatic cord

Price RUB 1500

Moscow, 2nd Kozhukhovsky proezd, 12, building 14
MCC ZIL station, Avtozavodskaya metro station (South Administrative District)

Why do an ultrasound of the scrotum and testicles?

The two testicles located inside the scrotum are the key paired organ of the male reproductive system. They produce sperm and the hormone testosterone.

Ultrasound of the testicles and scrotum is a painless and safe (no radiation) procedure. The only discomfort she can cause is associated with embarrassment and the need to be naked. And if there are complaints of pain in the scrotum, then when you touch the sensor, you can feel this pain. But the maximum duration of the entire procedure with preparation is 10-20 minutes, after which the doctor will immediately be able to prescribe adequate treatment.
Ultrasound of the scrotum is a mandatory procedure before obtaining an andrologist's opinion for an ART program.

It is a quick way to visualize the condition of the testicles and scrotal tissue. May be required for:

diagnosis of neoplasms in the scrotum (cyst, tumor, edema)

monitoring the state of tissues after injury

determining the source of pain

diagnostics of varicocele (dilated veins of the testicles)

testicular torsion determination

finding an undescended testicle

assessing the condition of the epididymis (with epididymitis)

How exactly does it show?

Ultrasound of the scrotum with doppler

Doppler ultrasound (Doppler) shows the movement of sperm along the vas deferens, narrowing or blockage that interferes with their flow. In addition, blood flow is critical for an erection, which is why Doppler ultrasound of the scrotum and penis is prescribed for erectile dysfunction.

The urologist or andrologist prescribes an ultrasound of the scrotum for severe and severe pain in the scrotum, when probing the seals, with oligozoospermia and azoospermia.

Preparation for ultrasound of the scrotum

No special training is required: no diet or bladder filling or scrotal hair shaving required.

Contraindications

Do not test if there are open wounds or ulcers on the surface of the skin of the scrotum. In this case, it is necessary to wait for the healing and restoration of the skin.

How is scrotal ultrasound performed?

The whole procedure takes no more than 15 minutes and does not require anesthesia.

An ultrasound scan is performed while lying on your back. The doctor may place a towel underneath to lift the scrotum.

All that is required of the patient: undress below the waist and lie down until the end of the study.

For better wave conduction, the doctor will apply a water-based gel to the transducer. It does not leave marks and does not feel sticky and can be easily removed with a napkin.

Possible Scrotal Ultrasound Results

If ultrasound detects pathological or abnormal tissues, formations and conditions, then, depending on their size and nature, it may be:

Testicular cyst

Usually a cyst is a consequence of a recent injury or inflammation. Most cysts are harmless and benign. It is a pouch of fluid that can be felt with your fingers. The task of ultrasound diagnostics is to determine and record the size of the cyst, its characteristics and good quality. Cysts can form in different tissues and parts of our body. If a cyst is detected, doctors adhere to observation tactics and recommend regular repeated ultrasounds to monitor it.

Epididymis cyst

Like a testicular cyst, this cyst does not require treatment or special concern. It differs from the testicular cyst only in its location. An epididymis cyst can be more painful than a testicular cyst.

Varicocele

On ultrasound of the scrotum, varicocele is recorded in 15% of men and more often in the left testicle. It develops due to a violation of the outflow of blood in the testicles, causing overextension of the veins and their expansion and weakening. In order to assess the degree of negative effect of varicocele on the blood flow, dopplerometry is used.

Hydrocele

This is a collection of fluid around the testicles within the scrotum. Usually does not cause any pain in patients. A hydrocele is not dangerous. The main thing that the doctor will be interested in is information about recent injuries and infections and the absence of neoplasms in the scrotal cavity. As a rule, hydrocele in adult men goes away on its own within 6-8 months. Congenital hydrocele can persist for life and if it has no effect on testicular function, it does not require treatment.

Blockages and narrowing of the vas deferens

Ultrasound of the scrotum can be prescribed when oligoazoospermia or azoospermia is detected. Those. when there are few or no sperm in the semen. The problem may be excessive narrowing or blockages of the seminal ducts. The path for sperm cells is either very difficult or completely blocked. The good news is that sperm are produced and they are there. But for the treatment it will be necessary to remove these obstacles, i.e. have testicular surgery.

Testicular tumors

Malignant testicular tumors are quite rare, although the frequency of their detection increases from year to year. There are some indications that the ultrasound-detected neoplasm is malignant. Therefore, the doctor will fix them and prescribe an additional scan of the scrotum (MRI, CT).

Testicular torsion

When overlapping, the testicle rotates around its axis, thereby pinching the nerves and blood vessels. Blood circulation is impaired, severe pains, swelling occur. Torsion requires urgent surgery.

Ultrasound of the prostate

As well as with the scrotum, ultrasound examination of the prostate allows you to assess its condition, identify a neoplasm, their size and nature.

Prostate ultrasound is required for all men over 40 due to the high prevalence of prostate cancer.

For what symptoms and complaints does a urologist prescribe an ultrasound of the prostate gland?

problems with urination (retention, pain, blood)

lumps and nodules around the rectum

low sperm count in semen analysis results

some deviations in the results of blood and urine tests

An ultrasound examination of the scrotum is a diagnostic procedure in which sound waves penetrate the tissues and allow the doctor to find out information about the condition of each organ. Such an examination is comfortable for the patient, and therefore doctors often prescribe it for "male" problems - after all, most men refuse painful manipulations. Ultrasound does not cause any discomfort. In addition, it is recognized as one of the most informative diagnostic methods. Note that this procedure allows you to identify pathological processes and developmental anomalies not only in adult men, but also in children.

The main advantages of examining the scrotum with ultrasound

This technique allows you to examine in detail the state and structure of the various membranes of the scrotum, testicles and spermatic cord. If the test is done with Doppler, the doctor can also assess blood flow and vascular health. After manipulation, the doctor deciphers the results. Note that thanks to timely diagnosis, it is possible to identify a lot of pathological processes even before the first symptoms appear, which allows early treatment to begin and avoid serious problems and complications in the future.

Of the advantages, the following factors can be noted:

• The man does not feel any discomfort or pain during the procedure.
• Ultrasonic waves have no negative effect on the body.
• The study is highly informative.

Like any medical manipulation, ultrasound has one drawback - when a neoplasm is detected, it is impossible to know whether it is a malignant tumor or a benign one. For this purpose, after the procedure, other diagnostic tests are prescribed (usually a biopsy).

When is ultrasound of the scrotum shown?

Due to the complex anatomical structure of the scrotum, ultrasound is almost the only way to identify an accurate diagnosis. This procedure is prescribed if the patient has symptoms of urological diseases or a history of concomitant diagnoses.

Carrying out a study of the organs of the scrotum is prescribed in the following situations:

• The impossibility of conceiving a child when on the part of the mother all tests and studies are normal;
• When probing the area of ​​the scrotum, a seal is found;
• Unstable erection;
• Pain in the testicles or other parts of the scrotum;
• Change in the size of the testicles or scrotum in general;
• Injury to this area;
• Poor sperm results.
• The appearance in this area of ​​a hematoma or a bright vascular network.

In addition, ultrasound of the scrotum is used for dynamic monitoring of the treatment process.

If you or your loved one is experiencing pain or discomfort in the scrotum, this is not the norm. According to statistics, most often painful sensations signal epididymitis - inflammation of the epididymis. With a timely visit to a doctor and early treatment, you can completely recover and forget about discomfort, while an advanced disease can lead to infertility.

Do you need special preparation for research?

For adult men, special training is not required. It is enough to thoroughly carry out hygienic manipulations in the morning before the procedure, and in case of abundant hair, remove hair from the studied area. If we are talking about children, it is not recommended to give the baby a drink in 1.5 hours, so as not to interrupt the procedure to empty the bladder. It is also worth telling the child about the upcoming study, mentally preparing so that the child remains calm and immobile during the examination.

In the event that ultrasound diagnostics with Doppler is to be performed, inform the doctor about taking vasodilator drugs. It may be necessary to discontinue the medication a couple of days before the proposed study.

How is scrotal ultrasound performed?

The procedure is carried out in an ultrasound diagnostic room. The patient removes all clothing below the waist and the doctor asks him to lie either on his back or on his side. The man should press the penis with his hands to his stomach. A special gel is applied to the scrotum area, which contributes to better contact of the sensor. On average, the manipulation does not exceed 15 minutes.

At the end of the ultrasound examination, the man is sent with the results of the procedure to the attending physician. The specialist determines the exact diagnosis and prescribes treatment if any pathology is detected.

Ultrasound of the scrotum organs with dopplerography

Sometimes the patient is prescribed an ultrasound scan with Doppler ultrasonography. Most often this occurs when an erection is impaired, in order to assess the functioning of the blood flow in the intimate area, as well as the structure and functionality of the vessels located in this area. With the help of such manipulation, it is possible at an early stage to identify the existing atherosclerotic plaques or blood clots.

Decoding the results

The diagnosis and interpretation of the data should be carried out by the attending physician who referred you to the examination of the scrotal organs. Don't try to diagnose yourself on your own.

After performing the manipulation, the doctor can detect such deviations from the norm:

• Cryptorchidism. This ailment is typical for boys under the age of 7. The essence of this pathological process is the absence of one testicle in the scrotum. The cause of the abnormality can be different. If such a nuisance is detected in a timely manner, the problem can be eliminated and infertility can be avoided in the future.
• Lumps and swellings. Experts assure that oncological diseases or benign tumor-like formations in the area of ​​the scrotum organs rarely occur, however, even at an early stage, this process will be clearly visible when performing an ultrasound examination. This is evidenced by fuzzy contours and lack of graininess.
• Calcifications and cysts. These pathologies can occur in both an elderly man and a newborn.
• Inflammatory process. Usually occurs due to traumatic damage to the scrotum or the introduction of pathogens with blood or lymph pathway. In this case, the patient usually understands that not everything is normal: there is a pronounced swelling of the scrotum, an increase in temperature in the groin area and soreness when touched.

Scrotum norm by ultrasound

If there are no pathological processes in the scrotum, then the length of the testicles should be about 5 centimeters, the thickness should not exceed three centimeters, the transverse size should be 1.5-2 cm; vertical size - 2.5-3 cm. Normally, the testicles have an oval shape, a homogeneous structure of increased echogenicity.

If, as a result of the study, pathological processes are revealed or your results do not coincide with the above-described norm, you should not be upset ahead of time. Each organism is individual and the size may vary slightly, and the final diagnosis can only be made by a doctor.

Doppler ultrasonography of the vessels of the penis, as well as the scrotum, helps to assess the compliance with the norm of blood circulation parameters in these organs. The method is based on the Doppler effect - the ability of an ultrasonic wave to change its length when it comes into contact with a static medium and is in motion. The USDG technique allows you to identify and promptly eliminate diseases of the reproductive system associated with blood flow disorders.

When research is needed

Doppler examination often complements ultrasound of the scrotum and penis, since it allows you to get a more complete picture of the state of the organs under discussion. The basis for the appointment of diagnostics is a suspicion of a pathological state of the vessels or their lumens, as a result of which blood stagnation occurs. Doppler ultrasonography of the penis is recommended for the following pathologies:

• Erectile dysfunction (to confirm its vascular origin).
• Penis injury.
• Peyronie's disease.
• Suspected vascular thrombosis.
• The appearance of neoplasms in the genital organ.
• Violation of the process of urination due to blockage of the urethral canal.

Ultrasound with dopplerography allows you to assess the state of the corpora cavernosa, the protein membrane of the penis, the correspondence of the diameter of deep and peripheral vessels to the norm, the speed of movement of venous and arterial blood. These characteristics help to refute or confirm the appearance of functional disorders due to organic changes in the normal structure of the penis.

Along with examining the member, doctors prescribe an ultrasound of the scrotum, supplemented by a Doppler. The technique allows you to assess the condition:

• Testicular tissue, compliance of its structure with the norm, absence of foreign inclusions.
• The spermatic cord and vas deferens, their correct position, no twists.
• The epididymis - to refute the destructive processes.
• The veins and arteries that feed the scrotum. Particular attention is paid to the plexus plexus to exclude varicocele.

A thorough examination of the genitals using ultrasound provides the specialist with a full amount of information necessary to establish the causes and choose the correct treatment for most diseases of the reproductive system.

Features of the survey

Before conducting an ultrasound scan with the Doppler effect, the patient needs to undergo simple preparation:

• 3 days before the procedure, stop drinking alcohol, smoking, visiting a bath or sauna, taking medications.
• Take a moderately warm shower 2 hours before the examination.
• Reduce fluid intake and be sure to urinate half an hour before the start of the study.

Doppler ultrasonography of the scrotum is performed in the absence of an erection, often in a horizontal position. If varicocele is suspected, the doctor may ask the patient to stand up and sharply tighten the anterior abdominal wall.

The penile Doppler requires a strong and stable erection, as the diagnosis will take about half an hour. A strong blood flow will provide a full expansion of the vessels of the penis for the most accurate assessment of the direction of blood flow, the normal tone of the arterial valves, as well as the thickness and permeability of the vascular walls.

To achieve an erection, pharmacological stimulation is considered the most reliable way. The cavernous body is injected with the drug Caverject or Vasoprostan. In the absence of contraindications, an injection into the penis can be replaced by taking tablets containing sildenafil. Visual and manual stimulation of an erection gives an unreliable result, because the disappearance of arousal makes diagnostics impossible.

Doppler ultrasound examination of the penis is carried out as follows:

• Before stimulating an erection, a hypoallergenic water-based gel is applied to the penis, which is necessary to ensure full contact of the sensor with the skin surface. The organ is examined at rest.
• A stimulating drug is administered by injection. With the help of a linear transducer, ultrasonic exposure occurs. Changes in the ultrasonic wavelength indicators undergo mathematical transformation and are displayed on the equipment monitor in the form of colored fragments.
• The doctor assesses the state of the vascular system of the genital organs, the speed and direction of blood flow, as well as the diameter and patency of the main vessels. All data are entered at the conclusion of the study.
• The patient is left alone to get rid of the erection by manual stimulation of the penis.

The last item on the list is required. If, after the introduction of a stimulating drug, an erection does not go away within four hours, the patient must urgently consult a doctor in order to avoid the onset of irreversible changes in the penis.

The price for an ultrasound scan with a Doppler varies from 1,500 to 3,000 rubles. The cost of diagnostics is set by each clinic separately, depending on its pricing policy.

Evaluation of results

Based on the results of ultrasound studies, the attending physician draws conclusions about the conformity of the structure of the tissues of the genital organ, as well as its vascular system. Basic Doppler data reflected by the protocol:

• During the maximum arousal of the penis, venous outflow through the deep dorsal vessel should stop. If this does not happen, then the patient has vascular erectile dysfunction.
• The index of resistance in a state of complete rest should exceed 0.8, at the beginning of the onset of excitement - 0.7, with maximum excitement of the organ - equal to 1.0.
• The normal ripple index should be greater than 4.
• Diastolic blood flow velocity through the arteries without the onset of excitement should correspond to 0 cm / s, with an erection - 10 cm / s.
• The peak of the blood flow velocity inside the arteries of the corpus cavernosum should be 25 cm / s in a calm state, with the onset of an erection, rise to 35 cm / s, with maximum arousal, be less than this figure. Smaller indicators indicate arterial insufficiency of the penis.
• During systole, the resistance of the arteries should remain high.

Only a doctor is able to correctly evaluate the results of the study and draw appropriate conclusions.

So, ultrasound examination of the vessels of the scrotum, as well as the penis, reflects the usefulness of the supply of blood to the genitals, the state of the venous and arterial walls. This method is able to detect any violation of the outflow-flow of blood, as well as the formation of blood clots in the lumen of the vessels, which allows you to start treatment in a timely manner.

Studies of male genital organs using ultrasound allow you to find 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. Doppler ultrasonography of the vessels of the penis and scrotum is necessary to assess the state of the blood supply system of these organs, because it is the normal blood flow that is the basis for the healthy functioning of all systems of the human body, including the reproductive system.

When a study is prescribed

The basis for 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 (enlargement of the inguinal lymph nodes, severe deviations in spermogram indices, pain in the groin, trauma). But sometimes, together with ultrasound, dopplerography of the penis is also prescribed, and, if necessary, of the scrotum.

The grounds for supplementing the usual ultrasound with the ultrasound method are suspicions of a violation of the blood supply to the penis or a change in the structure of its important blood vessels, which happens under the following conditions:

1. The formation of fibrous plaques accompanying the course of Peyronie's disease.
2. Trauma, dislocation, penile fracture or contusion.
3. Erectile dysfunction, which has arisen against the background of vascular pathologies.
4. Changes in the structure of the urethra.
5. Palpation detection of neoplasms in the structure of the organ. The study is necessary to determine the activity of its blood supply and the prospect of an increase in size.
6. The presence of a foreign body inside the urethra.
7. The formation of plaques, blood clots, fibrous nodes with partial or complete blockage of the lumen of important vessels.

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

The study is assigned in the presence of the following indications:

• The appearance of edema in the scrotum.
• Testicular contusion.
• Systemic diseases of the circulatory system, such as atherosclerosis or varicose veins.
• Neoplasms.
• Suspicion of an abnormality in the development of the scrotum of a congenital nature.
• Exposure to radioactive radiation.
• Suspected twisting of the spermatic cord.
• Cystic or varicose formations in the scrotum.