title: Unilateral idiopathic hydrocele has a substantial effect on the ipsilateral testicular geometry and resistivity indices.
abstract: OBJECTIVE
  The purpose of this study was to determine whether hydrocele has any effect on the volume and shape of the ipsilateral testis and can be implicated as a cause of testicular ischemia.
  
  
  METHODS
  Group 1 consisted of 23 patients with unilateral idiopathic hydrocele, whereas 30 healthy men constituted group 2. All patients underwent scrotal ultrasonography by which testicular dimensions in craniocaudal (D(cc)), anteroposterior (D(ap)), and mediolateral axes were measured, followed by calculation of the D(cc)/D(ap) ratio and testicular volume. By color Doppler analysis, the resistivity index of the subcapsular artery (RI(sc)) and the resistivity index of the intratesticular artery were determined.
  
  
  RESULTS
  The mean D(cc)/D(ap) ratio +/- SD for group 1 was 1.7 +/- 0.3 (range, 1.1-2.3), significantly lower than that of group 2, which was 1.9 +/- 0.3 (range, 1.3-2.2) (P = .028). Mean testicular volume values of subjects having hydrocele for more than and less than 6 months were 13.4 +/- 7.3 and 22.5 +/- 5.1 cm3, respectively; the difference between the subgroups was significant (P = .003). For the ipsilateral testis, mean RI(sc) values were 0.70 +/- 0.06 (range, 0.60-0.80) in group 1 and 0.65 +/- 0.06 (range, 0.59-0.83) in group 2. The mean RI(sc) was significantly higher in group 1 (P = .006).
  
  
  CONCLUSIONS
  Unilateral idiopathic hydrocele has a tendency for rounding rather than flattening the ipsilateral testis as well as elevating the RI(sc) on the affected side. To the best of our knowledge, no strict spectral Doppler analysis criteria have been proposed for testicular ischemia yet. Therefore, the impact of the difference of the RI(sc) should raise the suspicion for ischemia, and further research is needed to elucidate any effect on spermatogenesis.
authors.affiliation: Department of Radiology, Ankara Training and Research Hospital, Turkey. ahmettuncayturgut@yahoo.com
authors.forename: Ahmet Tuncay
authors.initials: AT
authors.lastname: Turgut
authors.forename: Alparslan
authors.initials: A
authors.lastname: Unsal
authors.forename: Eriz
authors.initials: E
authors.lastname: Ozden
authors.forename: Pinar
authors.initials: P
authors.lastname: Kosar
authors.forename: Ugur
authors.initials: U
authors.lastname: Kosar
authors.forename: Levent
authors.initials: L
authors.lastname: Emir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D006848:Testicular Hydrocele / Q000503:physiopathology*; D013737:Testis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D014463:Ultrasonography; D014655:Vascular Resistance