65 patients with penetrating or blunt scrotal trauma underwent scrotal ultrasound. High-resolution real-time sonography was able to differentiate testicular from extratesticular lesions in all cases. Lesions of the epididymis were diagnosed in 14 cases. In epididymal haematoma sonography revealed an hyperechoic enlarged epididymis whereas posttraumatic epididymitis was demonstrable as hypoechoic swelling. 14 testicular ruptures and 6 testicular haematomas without disruption of the tunica albuginea were correctly diagnosed. Diagnosis could be confirmed at operation in 12 cases and by clinical and sonographic follow-up in 8 cases. A heterogeneous parenchymal pattern, contour abnormalities, poorly defined margins and obvious fragmentation of the testicle strongly suggest testicular rupture.
During the course of four and a half years, transrectal sonography was performed in 724 men; in each case the seminal vesicles and prostate were evaluated. In 149 examinations, changes were found in the seminal vesicles and in 143 of these, the sonographic finding suggested that the changes were due to prostatic disease. In 95 histologically proven prostatic carcinomas, infiltration of the seminal vesicles could be demonstrated. In three patients there was an empyema and in three others a malformation of the seminal vesicles. Prostatic sonography is essential for accurate diagnosis of the basic abnormality.
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