Ultrasound - Scrotum

Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissues. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum. Ultrasound is safe, noninvasive, and does not use ionizing radiation.


What is Ultrasound Imaging of the Scrotum?

Ultrasound imaging of the scrotum provides pictures of a male’s testicles and the surrounding tissues.



What are some common uses of the procedure?

Ultrasound imaging of the scrotum is the primary imaging method used to evaluate disorders of the testicles, epididymis (a tube immediately next to a testis that collects sperm made by the testicle) and scrotum.

This study is typically used to:

  • determine whether a mass in the scrotum felt by the patient or doctor is cystic or solid and its location.
  • diagnose results of trauma to the scrotal area.
  • diagnose causes of testicular pain or swelling such as inflammation or torsion.
  • evaluate the cause of infertility such as varicocele.
  • look for the location of undescended testis.

A sudden onset of pain in the scrotum should be taken very seriously. The most common cause of scrotal pain is epididymitis, an inflammation of the epididymis. It is treatable with antibiotics. If left untreated, this condition can lead to an abscess or loss of blood flow to the testicles.

Ultrasound can often detect an absent or undescended testicle as well. It is estimated that approximately three percent of full-term baby boys have undescended testicles. The testicle normally migrates from the abdomen, down the inguinal canal and then into the usual position in the scrotal sac. If not present in the scrotal sac, the testicle may have stopped on its way and lie in the inguinal region, in which case the ultrasound examination will often see it. If the testicle has not left the abdominal cavity, it may not be seen by sonography. If a testicle is not detected, a urologist may be consulted in order to decide whether additional imaging such as an MRI is needed to determine its location. If the testicle is found to be in the inguinal region, it can be moved into the scrotum. If left in the abdomen too long, it may become cancerous and may need to be removed.

Ultrasound can identify testicular torsion, the twisting of the spermatic cord that contains the vessels that supply blood to the testicle. Caused by abnormally loose attachments of tissues that are formed during fetal development, torsion commonly appears during adolescence, and less often in the neonatal period, and is very painful. Torsion requires immediate surgery to avoid permanent damage to the testes.

Ultrasound also can be used to locate and evaluate masses (lumps or tumors) in the testicle or elsewhere in the scrotum. Collections of fluid and abnormalities of the blood vessels may appear as masses and can be assessed by ultrasound. Masses both outside and within the testicles may be benign or malignant and should be evaluated as soon as they are detected.

How should I prepare?


You may be asked to wear a gown during the procedure.

No other preparation is required.

What does the equipment look like?



In order to perform a scrotal sonogram, most commonly a linear small parts transducer is used.

How does the procedure work?




How is the procedure performed?





What will I experience during and after the procedure?

Ultrasound examinations are painless and easily tolerated by most patients.

Ultrasound imaging of the scrotum is usually completed within 15 to 30 minutes, though sometimes more time is necessary.



Who interprets the results and how do I get them?



What are the benefits vs. risks?




What are the limitations of Scrotal Ultrasound Imaging?

Ultrasound of the scrotum is helpful for finding abnormalities such as masses in the scrotum or testicles. However, it does not always permit an exact diagnosis (i.e., the exact type of tissue a mass is composed of, especially when the mass is solid). Blood flow images of the testicles are not always reliable in determining the presence or absence of blood supply to a testicle that has twisted. When searching for an absent testicle, ultrasound may not be able to find it if it is located in the abdomen because gas filled bowel loops may block the view.

This page was reviewed on June 19, 2015


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