Use of Radioisotope Testicular Scanning in the Evaluation of the Acute Scrotum

Lee, Youn Soo; Choi, Hyung Ki; Kwnon, Sung Won

Abstract

Acute scrotum is defined as an acute, painful testicular swelling and is very difficult differential diagnosis due to equivocal clinical symptoms and signs. But until 5 years ago, no imaging procedures existed in the evaluation. So many testes were lost due to delay of adequate treatment and surgery under the misdiagnosis Recently the radioisotope testicular scanning in the imaging procedures has been introduced as that is a simple, safe and rapid method and had a high accuracy. Twenty-nine cases with scrotal swelling and pain were studied by means of testicular scanning in the Department of Urology, Severance and Ewha Woman's University Hospital, During the period from August 1981 to July 1982. The following results were obtained. 1. There were five cases in whom the scan findings was compatible with torsion of testis. The diagnosis was conformed by operation. 2. Exploration of scrotum was not performed in twelve cases showing increased perfusion because the history and physical findings were compatible with epididymitis. All cases were well improved by antibiotic therapy. 3. In the 2 cases of not improved epididymitis, abscess formation was early found by repeated scan. 4. On the scrotal image, increased activity is seen in epididymitis, abscess and tumor, but decreased activity is seen testicular torsion and hematoma. 5. The scan findings correlate closely with the clinical course or the findings at surgical exploration on the acute scrotum. So above results, the scan is a well established, easily available and accurate technique used routinelyto assist in the clinical evaluation of patients with acute scrotal pain and swelling.