Doppler Ultrasonography of scrotum and spermatic vessels

Echocolordoppler of the spermatic vessels represents the main imaging technique for the study of varicocele. The examination is performed first in clinostatism and then in orthostatism. The B-Mode evaluation allows us to detect the presence of dilated venous vessels (diameter > 3mm) along the inguinal canal or inside the scrotal sac, while the echolordoppler (ECD) survey gives us information on the presence or absence of reflux and whether the latter is present in basal conditions and/or after increased intra-abdominal pressure (Valsalva maneuver). The classification of varicocele is both clinical and ultrasonographic. Echocolordoppler of the spermatic vessels is also of fundamental use in emergency conditions such as torsion of the spermatic or testicular funiculus (2). In this case, the doppler effect allows to evaluate the testicular vascularization that if extremely reduced or absent needs a rapid surgical treatment.       

The examination requires an advanced ultrasound apparatus, equipped with a linear probe and the possibility of observing the blood flow in the form of colored images, using the physical phenomenon called "Doppler effect". The scrotal ultrasound is performed in two phases: the first with the patient in supine position who is asked to keep the penis resting on the suprapubic area and the second in orthostatic position to better assess the presence of any reflux along the pampiniform plexus, testicular malposition or the extent of any liquid collections.