Jawad Ali Memon, Adnan Ahmed, Mumtaz Ahmed Qureshi, Hafeez ur Rehman, Tahir Baig, Rabia Shah
Pakistan Journal of Medical & Health Sciences

Diagnostic Accuracy of Doppler Ultrasonography for Diagnosis of Epididymo-Orchitis in Patients presenting with Scrotal Swelling

Jawad Ali Memon, Adnan Ahmed, Mumtaz Ahmed Qureshi, Hafeez ur Rehman, Tahir Baig, Rabia Shah



Background and Aims: Epididymitis, orchitis, testicular torsion and appendix testis torsion causes most common and acute scrotal pain. The scrotal pain and complications could be diagnosed with Doppler ultrasound and histopathology post-surgery procedures. The current study aims to determine diagnostic accuracy of Doppler Ultrasonography for diagnosis of epididymis-orchitis in patients presenting with Scrotal Swelling.

Materials and Methods: This cross-sectional study was carried out on 121 scrotal masses patients during the period from April 2020 to September 2020 at the radiology department ofLiaquat University of Medical and Health Sciences, Jamshoro. Individuals who met the inclusive criteria were enrolled and consent form was taken from each patient. The patient’s age range was 15 to 68 years old with mean ± SD 34.5 ± 12.4. All the patients were presented with scrotal swelling. After history taken from the individual, Doppler ultrasound (DUS) was conducted. The final outcomes were compared by radiologist and surgeon. All the patients were subjected to linear transducer and Toshiba Xario 200 with 11MHZ. Diagnostic accuracy of Doppler ultrasound was calculated from the sensitivity and specificity.

Results: Doppler ultrasound diagnosed allthe epididymitis and orchitis, testicular torsion, hydrocele, spermatic cordinjury, and varicocele cases with specificity and sensitivity 100%. The frequencyof finally diagnoses performed by Doppler ultrasonography was orchitis (7),epididymitis-orchitis (45), testicular malignancy (15), spinal cord injuries(3), testicular torsion (5), hematocele (3), spermatic cord injuries (2),varicocele (14), hydrocele (25), and pyocele (2). Out of 15 testicular subjectsdiagnosed on DUS, only 14 were found to have malignancy. Two cases ofOrchitis were diagnosed falsely as amalignancy. In Orchitis 7 patients, 6 were diagnosed as orchitis but one hadseminoma (specificity 67% and sensitivity 88%). The overall DUS specificity andsensitivity were 67% and 98% respectively.

Conclusion: The scrotal disease can be diagnosed with effective, reliable, and safe Doppler Ultrasonography. Testicular tumor diagnosis is an additional advantage of DUS besides minimizing unnecessary exploration operations numbers. Doppler ultrasonographyplays a vital role in need of immediate diagnosis of testicular torsion.

Keywords: Doppler ultrasound scan, Scrotal pathologies, Epididymo-Orchitis

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