Scrotal and Testicular Ultrasound in Ajax: A Plain Guide

Plenty of men would rather not talk about this part of the body, let alone have it examined. That reluctance is understandable, but it can also lead to delays, and a scrotal ultrasound is one of the simplest, quickest and most informative tests a health-care provider can order for this area. It uses no radiation, it involves no needles, and for most people it is over well before they have finished worrying about it.

This guide sets out the facts plainly. It covers what the scan looks at, the usual reasons it is requested, how the appointment works, and what the test can and cannot tell you. If you live in Ajax, Pickering, Whitby or elsewhere in Durham Region and have been handed a requisition for a scrotal or testicular ultrasound, this should answer most of your questions before you arrive.

First, a word about emergencies

Sudden, severe pain in a testicle, especially if it comes on over minutes or hours, wakes you from sleep, or comes with nausea or vomiting, needs urgent attention. One possible cause is testicular torsion, where the blood supply to the testicle becomes twisted, and it is time-sensitive.

If you or your child has sudden, severe testicular pain, call 911 or go to the nearest emergency department straight away. Do not wait for a booked appointment. A community imaging clinic is the right place for planned investigations, not for emergencies.

The same applies to a significant injury to the groin, or to pain with a high fever and rapidly increasing swelling. Everything else in this article is about scans that have been planned with a health-care provider.

What the scan actually looks at

“Scrotal ultrasound” and “testicular ultrasound” are usually used to mean the same exam. It looks at the contents of the scrotum, which include:

• The testicles, checking their size, shape and internal texture, and comparing one side with the other
• The epididymis, a coiled tube that sits along the back of each testicle and stores sperm
• The spermatic cord, which carries blood vessels and the tube that transports sperm
• The surrounding fluid and tissue layers, where collections of fluid can build up

Most scans also use Doppler, a setting that shows blood flow in colour. Comparing blood flow between the two sides can give the radiologist useful information.

Why a provider might order it

People are referred for this scan for many different reasons, and most of them turn out to be explained by something common and manageable. Typical reasons include:

A lump or a change you have noticed

A provider will often order an ultrasound to look at a lump found during a self-check or a physical exam. One of the most useful things the scan does is show whether the lump is inside the testicle itself or in the structures next to it, which matters a great deal for what happens next. Many lumps sit outside the testicle and are harmless, such as small cysts in the epididymis.

Swelling

A scrotum that looks or feels larger on one side may have a fluid collection around the testicle (a hydrocele), a collection of enlarged veins (a varicocele), or swelling related to inflammation. Ultrasound can usually tell these apart.

Ongoing or recurring discomfort

Aching or discomfort that has been present for a while, rather than sudden severe pain, is a common reason for a planned scan. Inflammation of the epididymis is one of the conditions a provider may want to look for.

Fertility investigations

When a couple is having difficulty conceiving, a provider may request a scrotal ultrasound as part of a broader assessment, for example to look for a varicocele.

Follow-up

If something was seen on an earlier scan, a repeat ultrasound may be ordered to check whether it has changed.

How privacy is handled

This is the question most men want answered and few ask out loud, so here it is.

You will be shown to a private room and asked to undress from the waist down. You will be given a gown, a sheet or a towel to cover yourself. During the scan, only the area being examined is exposed, and a towel is commonly placed beneath the scrotum to support it and keep it still. You may be asked to hold the penis up against your abdomen, covered by a towel or sheet.

Sonographers carry out this exam routinely. Their focus is on getting clear images, and they are used to patients feeling awkward. If you have a preference about the person performing your scan, or questions about having someone else present in the room, call the clinic before your appointment to ask what can be arranged. It is better to raise it on the phone than to feel uncomfortable on the day.

Step by step through the appointment

1. Check in. Bring your health card and your requisition. Let the front desk know if anything has changed since your provider wrote the requisition.
2. Change. You will be shown where to undress and how to cover up.
3. Lie on your back. The bed is adjusted so you are comfortable, with your legs slightly apart.
4. Gel and transducer. The sonographer applies warm gel and moves a small handheld transducer gently over each side. The pressure is light.
5. Both sides are scanned. Even if only one side is bothering you, the other side is usually examined for comparison.
6. Possible extra steps. You may be asked to take a deep breath and bear down, as if straining, which helps show whether veins enlarge. Sometimes this is also checked while standing.
7. Clean up and dress. You will be given tissues or a towel to wipe off the gel.

If you have pain in the area, tell the sonographer before they begin. They can adjust their pressure and work around the most tender spot as much as possible.

Preparation

Scrotal ultrasound generally needs very little preparation. There is usually no need to fast or to fill your bladder. Wear comfortable clothes that are easy to remove, and plan to arrive a few minutes early. The clinic will confirm any instructions specific to your exam when you book.

If the scan is part of a broader set of tests, for example combined with an abdominal ultrasound, your preparation may be different, and the instructions for the abdominal part usually take priority. Our guide on preparing for an abdominal ultrasound covers fasting if that applies to you.

What the scan can and cannot tell you

Ultrasound is the main imaging test for the scrotum for good reason. It gives detailed pictures of the testicles and nearby structures, shows blood flow, and is comfortable and quick.

It does have limits:

• It describes rather than labels. The report will describe what was seen, its location, size and appearance. Putting that together with your symptoms and examination is your provider’s job.
• It may lead to other tests. Depending on the findings, your provider may order blood tests, a repeat scan, or a referral to a specialist.
• It is a snapshot. If symptoms change after the scan, especially if pain becomes sudden or severe, seek care again rather than relying on the earlier result.

As with all imaging at our clinic, the sonographer captures the images and the report is sent to the provider who ordered the exam. They will go over the results with you. The process is explained in our article on how imaging results reach your doctor.

Questions to take to your follow-up visit

Once the report has reached your provider, a short list of questions can make the conversation more useful. You might ask:

• Was the area of concern inside the testicle or in the tissue next to it?
• Does the finding need treatment, monitoring, or nothing further?
• Will I need a repeat ultrasound, and roughly when?
• Are there symptoms that should bring me back sooner, or send me to the emergency department?
• Does this affect fertility, if that is something I am thinking about?

Many men in Ajax and the surrounding area tell us the scan itself was far less daunting than the days spent putting it off. Bringing written questions helps make sure the follow-up visit is just as productive.

About self-checks

Many health organizations encourage men to become familiar with how their testicles normally look and feel, so that changes are noticed early. The idea is not to diagnose yourself, but to know your own baseline. A good time is after a warm shower, when the scrotal skin is relaxed.

If you notice a new lump, a change in size or firmness, a feeling of heaviness, or an ache that does not settle, book an appointment with your health-care provider. They will examine you and decide whether an ultrasound or another test is the right next step. Testicular concerns can affect men of any age, including young adults, so age is not a reason to put it off.

Key takeaways

• Sudden, severe testicular pain is an emergency: call 911 or go to the emergency department.
• A scrotal ultrasound is quick, uses no radiation and usually needs no special preparation.
• Both sides are normally scanned, and you may be asked to bear down or stand.
• Privacy is maintained with gowns and towels, and you can call ahead with any concerns.
• Results go to the provider who ordered the scan, who will discuss them with you.

Booking your scan

Rossland Diagnostic Clinic provides general ultrasound for scans ordered by your health-care provider at Unit 102, 300 Rossland Road East in Ajax, a short drive for patients from north and south Ajax, Pickering and Whitby. We have free parking and ground-floor access, and we are open Monday to Friday from 9:00am to 5:00pm and Saturday from 8:00am to 3:30pm.

When you have your requisition, call 905-426-3111 or request an appointment. If anything about the exam is on your mind, mention it when you call, and we will do our best to answer it.