title: Color Doppler ultrasonography as a routine clinical examination in male infertility.
abstract: OBJECTIVE
  We assessed the value of scrotal color Doppler ultrasonography as a routine examination in infertile men.
  
  
  METHODS
  Color Doppler ultrasonography was performed in 545 infertile men with a mean age of 35.8 years to detect intrascrotal abnormalities. Findings were compared with those of physical examination.
  
  
  RESULTS
  Intrascrotal abnormalities were detected by ultrasonography in 65.3% of patients. Of 374 abnormalities, 58.3% were undetected by physical examination. Left varicocele was found in 313 patients (57.4%); testicular microlithiasis in 30 (5.5%); epididymal cyst in 21 (3.9%); right varicocele in 4 (0.8%); and testicular cysts in 3 (0.6%). One occurrence each (0.2%) was found for testicular tumor, intrascrotal hemangioma, and hydrocele of the spermatic cord. Compared to ultrasonography, sensitivity in detecting left varicocele by physical examination was 58.4%; specificity, 79.3%; accuracy, 67.3%; and positive predictive value, 79.3%. Venous diameters in the pampiniform plexus were 3 mm or more in 61.5% of 130 subclinical left varicoceles. Of 30 patients with testicular microlithiasis, 14 had varicocele, 2 had epididymal cyst,s 3 had a history of mumps orchitis, 1 had retractile testis, and 1 had a history of orchiectomy for contralateral testicular tumor.
  
  
  CONCLUSIONS
  The routine Color Doppler ultrasonography is valuable for diagnosing scrotal abnormalities in infertile men, frequently detecting non-palpable lesions.
authors.affiliation: Department of Urology, Showa University Fujigaoka Hospital, Showa University School of Medicine, Kanagawa, Japan. hs-showa-u@med.showa-u.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Saito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shichizyo
authors.forename: Kimiyasu
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Atushi
authors.initials: A
authors.lastname: Igarashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D003560:Cysts / Q000000981:diagnostic imaging; D006801:Humans; D007248:Infertility, Male / Q000000981:diagnostic imaging* / Q000209:etiology; D020347:Lithiasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010173:Palpation; D012611:Scrotum / Q000000981:diagnostic imaging*; D013088:Spermatocele / Q000000981:diagnostic imaging; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color; D014646:Varicocele / Q000000981:diagnostic imaging*