Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

Abstract

ObjectiveTo determine and compare the spectrum of scrotal abnormalities in fertile and sub-fertile west African men using scrotal US. Subjects and methodsThe study examined 249 subjects over a period of 13 months. The subjects comprised 149 patients with diagnosis of male infertility, as well as 100 healthy individuals for comparison. The relevant clinical history of each patient was extracted from their case notes. All the subjects had their testes examined using a high frequency (7.5MHz) linear transducer of an ultrasound scanner. Images in B-mode ultrasound scan and color Doppler were acquired in the supine and upright position. The results were expressed as percentages and tests of significance were done using the chi-square and Fisher's t-test. A P-value<0.05 was considered statistically significant. ResultsThe prevalence of abnormal scrotal findings in the sub-fertile and fertile men was 65.1% and 23% respectively (P<0.01). Varicocele was the commonest and was found in 55% and 12% of the fertile and sub-fertile men respectively (P<0.01). Hydrocele and epididymal abnormalities were the next common with higher prevalence in the sub-fertile men (P>0.05), while testicular tumor was confirmed in one sub-fertile patient. With the exclusion of varicocele, there was no statistically significant difference in the prevalence of the other abnormalities between the sub-fertile and fertile groups. ConclusionMale sub-fertility was associated with a higher prevalence of scrotal abnormalities. Apart from the diagnoses of the possible causes of the sub-fertility, routine scrotal US was able to diagnose other abnormalities of clinical relevance in the sub-fertile male. Scrotal US is a valuable tool in the evaluation of the sub-fertile west African man and should be considered in the routine evaluation of the sub-fertile west African man.