Scrotal (Testicle) Ultrasound

What it is

The contents of the scrotum sit close to the surface, which is ideal for ultrasound: a high-frequency probe held against the skin can resolve the inside of a testicle in fine detail. The study images each testicle, the epididymis coiled behind it, the surrounding fluid layer and the veins of the cord above. Doppler is normally part of it, showing whether blood is flowing into each testicle and in which direction it moves through the veins — a question that plain images cannot answer and that changes the diagnosis entirely.

Why it is done

• To find out what a lump felt in the scrotum actually is, and whether it is inside a testicle or outside it
• To investigate sudden severe pain, where a twisted cord cutting off blood supply has to be identified quickly
• To evaluate pain or swelling that has come on more gradually, which often points toward inflammation or infection
• To look for enlarged veins that can be relevant in an infertility evaluation
• To assess the scrotum after an injury
• To locate a testicle that has not descended

What to expect

No preparation is needed; wear something easy to change out of. You lie on your back and a towel is placed to support the scrotum and to keep the penis out of the field. The sonographer applies warm gel and moves the probe across each side in turn, comparing them. If an area is already tender, the pressure can be briefly uncomfortable, and it is worth saying so. The scan generally takes around twenty to thirty minutes. Many men find the exam awkward more than painful; a chaperone can usually be requested. A radiologist reads the images afterward, though in an urgent case the result is often communicated the same visit.

Questions worth asking

• Is Doppler included in this study, or billed as an additional code?
• If this is being done in an emergency department for sudden pain, what are the separate charges — emergency facility, physician, and imaging?
• If this is part of a fertility workup, is it covered under my plan's diagnostic imaging benefit or under a fertility benefit with different rules?
• If a finding needs a follow-up scan in a few months, what would that repeat cost?