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Ultrasound imaging of the scrotum provides pictures of the testicles and the surrounding tissues of a man or a boy. Ultrasound imaging of the scrotum is the primary imaging method used to evaluate disorders of the testicles.


The procedure

For most ultrasound exams, the patient is positioned lying face-up on an examination table that can be tilted or moved.

A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin. The sonographer or radiologist then presses the transducer firmly against the skin and sweeps it over the area of interest.

This ultrasound examination is usually completed within 15 minutes.


Background Information

This study is typically used to:

  • determine whether a mass in the scrotum felt by the patient or doctor is cystic or solid.
  • 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.


Ultrasound is also a valuable tool for evaluating the epididymis (a tube that collects sperm made by the testicles) and the prostate. A sudden onset of pain in the scrotum may be very serious. 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 detect an absent or undescended testicle as well. In rare cases a testicle may fail to develop. More often, patients have an undescended testicle. It is estimated that approximately three percent of full-term baby boys have undescended testicles. It's important to diagnose an undescended testicle because it has a very high probability of developing cancer if left untreated.

Ultrasound can identify testicular torsion, the twisting of the spermatic cord that contains the vessels that supply blood to the scrotum. Caused by abnormally loose attachments of tissues that are formed during fetal development, torsion commonly appears during adolescence 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 scrotum. The majority of scrotal masses are located outside of the testes. Most masses found outside the testicles are benign or non-cancerous; most inside the testicles are malignant or cancerous. Collections of fluid and abnormalities of the blood vessels may appear as masses and can be assessed by ultrasound.


What are the limitations of Scrotal Ultrasound Imaging?

Ultrasound of the scrotum does not always permit distinction between benign and malignant conditions.


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