1427: Sonographic Features of Vasectomy Related Abnormality in the Scrotum: Revisited

Abstract

Vasectomy is one of the most effective methods of male fertility control. In general, it is a safe procedure, but, acute and chronic complications can be developed. The aim of this exhibit was to present the sonographic changes in the epididymis after vasectomy and illustrate various vasectomy related abnormal conditions. The medical records and sonographic findings of patients with history of vasectomy were reviewed. We collected vasectomy related abnormalities. Chief complaints of patients with vasectomy were scrotal mass, scrotal pain and scrotal enlargement. In patients with scrotal pain after vasectomy, the sonographic findings included enlargement of epididymis with ill-defined border. Hematoma and hematocele can be associated. The typical sonographic changes in the epididymis after long-term vasectomy were mainly epididymis thickening and epididymal tubular ectasia, mostly with no or diminished blood flow in the epididymis. The spermatoceles and sperm granulomas were typically associated with vasectomy. Spermatoceles have various sonographic findings from multilocular cyst, cystic lesions with low-echo levels to solid mass. Sperm granulomas showed well-circumsecribed heterogeneous mass in the epididymis. Epididymal tumor could not be excluded in those masses. The Hydroceles, varicocele and epididymal cysts can be also associated, however, these are nonspecific. When radiologists encounter such changes of epididymis, it would be useful to get history of vasectomy for correct diagnosis. To avoid an incorrect diagnosis, it is important to be aware of the typical and atypical sonographic features of vasectomy related abnormalities.