Ultrasound Evaluation of Testicular Volume in Patients with Testicular Microlithiasis

Abstract

Purpose Ultrasonography is a useful tool to measure testicular volume. According to the European Society of Urogenital Radiology, the combination of testicular atrophy and testicular microlithiasis (TML) is a risk factor for testicular cancer. Testicular atrophy is defined as a volume of less than 12 ml. The aim of this study was to compare testicular volume in patients with TML to patients with normal testicular tissue. Materials and Methods From 2013 to 2015 we included a total of 91 adult patients with TML, and 91 adult patients with normal testicular tissue as a control group. All patients underwent scrotal B-mode ultrasound investigation including measurement of width, length and height in both testicles. Testicular volume was calculated using the formula π/6×length×height×width. Results The median age for patients with TML was 48 years (range: 19-94 years), and 48 years (range: 20–75 years) in patients with normal tissue. No statistically significant difference was found between total testicular volume (both testes) >30 ml in patients with TML compared to patients without (OR 0.77 (95% CI 0.43-1.38, p=0.37). However, patients with TML tended to have lower testicular volume compared to patients without TML, when investigating testicular volume below 12 ml. Conclusion Overall, no association was found between testicular volume and TML, but there was a trend indicating that severe atrophy is often seen in patients with TML compared to patients without TML. However, a significant difference was only found in testicular volume ≤8 ml.

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Scrotal ultrasound reference ranges and associations with clinical, seminal, and biochemical characteristics

“…This is relevant, because below these thresholds “testicular hypotrophy” can now be defined in an evidence‐based way. Until now, a TV < 12 ml had been proposed to indicate testicular hypotrophy at US using the ellipsoid formula 47,48 or irrespective of the mathematical formula used, 49 however without evidence‐based data. Previously, a TV < 10 ml using the Lambert's formula was reported to be associated with testicular dysfunction, however evaluating only Japanese men with infertility 42,50 …”

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: An overview on male genital tract ultrasound reference ranges

“… 12 , 21 , 34 , 36 In the EAA US study, the lower limit for right and left testis was 12 and 11 mL, respectively, allowing to define “testicular hypotrophy” in an evidence‐based way. Previous studies defined testicular hypotrophy for a TV < 12 mL 37 , 38 or < 10 mL, 39 , 40 however, with no evidence. TV reflects the sperm production and hormonal status of the subject as well as the presence of previous or current testicular or systemic disorders.…”

Spermotrend Improves Semen Quality and Infertility in Men with Varicocele &lt;br/&gt;—Spermotrend and Male Infertility

“…Testicular volume was calculated using the formula π/6 × length × height × width. A testicular volume of less than 12 mL was suggested as testicular hypotrophy, with a testicular differential volume (DV) of less than 20% [40].…”