Riassunto analitico
Background: Testis ultrasound (US) should be included in the routinely performed diagnostic work-up of patients attending Units of Andrology. Although the real predictive role of US characteristics is still debated, they should be registered during the examination, aiming at increase the diagnostic ability of the clinician. Testicular volume (TV) and US inhomogeneity are proposed to be suggestive of impaired testicular function, although their role in other clinical conditions remains controversial.
Aim of the study: this study was designed to describe the role of US findings within the diagnostic work-up of patients referring for andrological reasons.
Methods: This was a retrospective, observational, cohort study. All consecutive outpatients undergoing single-operator testis US (Modena, Italy) from March 2012 to March 2018 were enrolled, matching for each patient ultrasound findings, hormonal and seminal data. No specific inclusion and exclusion criteria were provided.
Results: A total of 240 men were referred and assessed for infertility, suspected hypogonadism, erectile dysfunction, or gynecomastia. Considering the final diagnosis, in the hypogonadal group TV was significantly smaller compared to other groups (p<0.001) and men with hypergonadotropic hypogonadism had the smallest testes (p<0.001). Testicular inhomogeneity was more frequent in hypogonadal and infertile males (p<0.001). Microlithiasis was more common in men with hypogonadotropic hypogonadism (p<0.001). Moreover, right (p<0.001) and left (p=0.004) varicocele were more frequent in patients of infertility group, compared to other groups. In hypogonadal men TV seems to correlate with the severity of seminal parameters’ impairment.
Conclusion: Our study describe the role of US characteristics in the diagnostic work-up of different andrological conditions, considering both the reasons for andrological consultation and the final diagnosis. Being US inhomogeneity more frequently encountered in hypogonadism and infertility, its association with impaired testicular function seems to be confirmed, suggesting that testis US pattern could be more informative in the diagnostic work up of infertility and hypogonadism. Similarly, TV seems to be useful in the diagnostic work-up, confirming the detection of low TV in patients with a reduced testicular function, considering both infertility and hypogonadism.
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