Can Scrotal Contraction Affect Ultrasound Results for Varicocele?

Q: Can Scrotal Contraction Affect Ultrasound Results for Varicocele?

Hello： Is it possible that scrotal contraction could prevent an ultrasound or physical examination from detecting a varicocele issue? --> It should not be the case, but you may discuss it with your physician. <br>Wishing you good health.

Regarding testicular ultrasound (varicocele)?

A few days ago, I experienced some discomfort and a slight burning sensation in my left testicle (I also felt it a bit while lying down at night, but it doesn't significantly affect me when walking during the day).
Therefore, I visited the urology department at the hospital, and the doctor arranged for an ultrasound examination.
However, while lying on the examination table, my scrotum was in a contracted state, possibly due to the cold temperature or my nervousness, which may have affected the palpation and ultrasound examination.
After the examination, the doctor stated that no tumors or varicocele were found, and there were no signs of inflammation (I haven't had a fever in the past few days), so I was advised to monitor the situation for a few weeks.
I would like to ask the doctor if scrotal contraction could potentially prevent the ultrasound or palpation from detecting a varicocele, as I have noticed features resembling worms in the appearance of my scrotum at home.
Thank you for your assistance.

Niming, 20~29 year old female. Ask Date: 2022/05/16

Dr. Du Shixi reply Urology

Hello: Is it possible that scrotal contraction could prevent an ultrasound or physical examination from detecting a varicocele issue? --> It should not be the case, but you may discuss it with your physician.
Wishing you good health.

Reply Date: 2022/05/16

More Info

Scrotal contraction can indeed affect the results of an ultrasound examination for varicocele. The scrotum is designed to regulate the temperature of the testes, which is crucial for sperm production and overall testicular health. When exposed to cold temperatures or due to emotional stress, the scrotum may contract, pulling the testes closer to the body. This contraction can make it more challenging for the ultrasound technician or physician to visualize the blood vessels in the scrotum, including the pampiniform plexus, which is where varicoceles typically occur.

Varicoceles are characterized by the enlargement of the veins within the scrotum, similar to varicose veins in the legs. During an ultrasound, the technician looks for signs of these enlarged veins, which may be more prominent when the scrotum is relaxed. If the scrotum is contracted during the examination, it may obscure the view of these veins, potentially leading to a false-negative result where the ultrasound does not detect the presence of a varicocele even if one is present.

In your case, since you experienced discomfort and a burning sensation in your left testicle, it is understandable that you might be concerned about the possibility of a varicocele. The fact that your doctor did not find any tumors, varicocele, or inflammation during the ultrasound is reassuring. However, if the scrotum was contracted during the examination, it could have limited the ability to detect a varicocele.

If you have observed characteristics resembling "worms" in the scrotum, it is essential to communicate this to your healthcare provider. This observation could indicate the presence of dilated veins, which may suggest a varicocele. It might be beneficial to schedule a follow-up ultrasound, preferably in a more relaxed environment or after ensuring that the scrotum is at a normal temperature, to allow for better visualization of the blood vessels.

In addition to ultrasound, your doctor may consider other diagnostic methods, such as a physical examination when the scrotum is relaxed or performing a Valsalva maneuver during the ultrasound, which can help to distend the veins and make varicoceles more apparent.
In conclusion, while scrotal contraction can affect ultrasound results, it is essential to maintain open communication with your healthcare provider regarding any symptoms or concerns you may have. If discomfort persists or if you notice any changes in the appearance of your scrotum, do not hesitate to seek further evaluation. Regular monitoring and follow-up can help ensure that any potential issues are addressed promptly.

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