PI-03 SCROTAL ULTRASOUND FOR PAIN: LOW FREQUENCY OF ABSOLUTE SURGICAL INDICATIONS

Abstract

You have accessJournal of UrologyPlenary Session I - Best Abstracts1 Apr 2015PI-03 SCROTAL ULTRASOUND FOR PAIN: LOW FREQUENCY OF ABSOLUTE SURGICAL INDICATIONS James Kashanian, Christopher D. Morrison, Daniel J. Mazur, Marah C. Hehemann, Daniel T. Oberlin, Mohammed Said, Valary Raup, Brian Trinh, Andrew Choi, and Robert E. Brannigan James KashanianJames Kashanian More articles by this author , Christopher D. MorrisonChristopher D. Morrison More articles by this author , Daniel J. MazurDaniel J. Mazur More articles by this author , Marah C. HehemannMarah C. Hehemann More articles by this author , Daniel T. OberlinDaniel T. Oberlin More articles by this author , Mohammed SaidMohammed Said More articles by this author , Valary RaupValary Raup More articles by this author , Brian TrinhBrian Trinh More articles by this author , Andrew ChoiAndrew Choi More articles by this author , and Robert E. BranniganRobert E. Brannigan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2902AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Scrotal ultrasound (US) is the most commonly used imaging modality to evaluate the etiology of scrotal pain. Often, despite the presence of a clear clinical (nonsurgical) diagnosis, this test is ordered to rule out the presence of more serious pathology requiring acute surgical intervention. We hypothesize that the majority of US performed for scrotal pain reveal normal or benign (i.e. hydrocele, spermatocele, varicocele, etc.) findings, and that a very small percentage of US reveal pathology that is an absolute indication for surgery. METHODS After receiving IRB approval, we conducted a retrospective review of all scrotal US performed at our institution from 2002 to 2014 for a clinical history of scrotal or testicular pain, ache, or discomfort. US findings were categorized as A) Normal; B) Benign Scrotal Pathology; C) Inflammatory/Infectious (i.e. epididymitis, orchitis, epididymoorchitis, or cellulitis); and D) Surgical (i.e. abscess, testicular solid tumor, or torsion). RESULTS A total of 18,593 scrotal US were performed at our institution from 2002-2014, of which 7,668 (41%) were done for scrotal or testicular pain, ache, or discomfort. Of the 7,668 US, 2,600 (33.9%) were normal. 3,616 (47.2%) revealed benign findings. 1,281 (16.7%) demonstrated an inflammatory/infectious process. 121 (1.55%) revealed findings that are absolute indications for surgery. Overall, 54 (0.70%) showed a scrotal or testicular abscess; 60 (0.78%) demonstrated a discrete mass suspicious for neoplasm; 12 (0.16%) had findings consistent with a testicular infiltrative process suspicious for sarcoid, leukemia, or lymphoma; and 45 (0.59%) were found to have a diagnosis of torsion or torsion/detorsion. Of note, 50 (0.65%) had findings of a testicular lesion that were too small to characterize. CONCLUSIONS To our knowledge, this is the largest data set addressing findings on scrotal US performed for pain. The vast majority, 81.1%, of scrotal US performed to evaluate scrotal pain revealed normal or benign pathology while 16.7% revealed an inflammatory/infectious process. Ultimately, only 1 out of every 65 (overall 1.55%) US for scrotal pain revealed findings that are absolute indications for surgery. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e409 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Kashanian More articles by this author Christopher D. Morrison More articles by this author Daniel J. Mazur More articles by this author Marah C. Hehemann More articles by this author Daniel T. Oberlin More articles by this author Mohammed Said More articles by this author Valary Raup More articles by this author Brian Trinh More articles by this author Andrew Choi More articles by this author Robert E. Brannigan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...