Obstet Gynecol Sci.  2021 Sep;64(5):393-406. 10.5468/ogs.21040.

Sonographic evaluation of fetal scrotum, testes and epididymis

• Soto
• González JLM
• Martínez MV
• Pérez RL
• Rivero IM
• Fernández ML
• Izquierdo OG
• Cendán JPM

• KMID: 2520260
• DOI: http://doi.org/10.5468/ogs.21040

Abstract

External male genitalia have rarely been evaluated on fetal ultrasound. Apart from visualization of the penis for fetal sex determination, there are no specific instructions or recommendations from scientific societies. This study aimed to review the current knowledge about prenatal diagnosis of the scrotum and internal structures, with discussion regarding technical aspects and clinical management. We conducted an article search in Medline, EMBASE, Scopus, Google Scholar, and Web of Science databases for studies in English or Spanish language that discussed prenatal scrotal pathologies. We identified 72 studies that met the inclusion criteria. Relevant data were grouped into sections of embryology, ultrasound, pathology, and prenatal diagnosis. The scrotum and internal structures show a wide range of pathologies, with varying degrees of prevalence and morbidity. Most of the reported cases have described incidental findings diagnosed via striking ultrasound signs. Studies discussing normative data or management are scarce.

Keyword

Prenatal diagnosis; Sonography; Urogenital system; Scrotum; Cryptorchidism

Figure

• 

  Fig. 1 Magnetic resonance imaging at 31 weeks of gestation. Arrowheads indicate a 1.0×1.2 cm mass located posterior to the scrotum corresponding to a perineal lipoma (reprinted with permission from Murase N, Uchida H, Hiramatsu K. Accessory scrotum with perineal lipoma diagnosed prenatally: case report and review of the literature. Nagoya J Med Sci 2015;77:501–6) [38].

• 

  Fig. 2 Penoscrotal hypospadias assessed with three-dimensional ultrasonography in rendering mode at 33 weeks of pregnancy, showing a short penis and evidence of testicles inside a bifid scrotum (arrows) (reprinted with permission from Rios LT, Araujo Júnior E, Nardozza LM, Caetano AC, Moron AF, Martins Mda G. Prenatal diagnosis and postnatal ultrasound findings of cloacal anomaly: a case report. Case Rep Pediatr 2012;2012:969860) [59].

• 

  Fig. 3 Bilateral hydrocele with peritesticular calcification at 28 weeks of gestation, suggesting a meconium periorchitis (arrows) (reprinted with permission from Ochiai D, Omori S, Ikeda T, Yakubo K, Fukuiya T. A rare case of meconium periorchitis diagnosed in utero. Case Rep Obstet Gynecol 2015;2015:606134) [61].

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  Fig. 4 Inguinoscrotal hernia visualized as a scrotal mass (50×46 mm) with mixed echostructure and regular walls, containing few small echo-free cystic areas on the right side (reprinted with permission from Massaro G, Sglavo G, Cavallaro A, Pastore G, Nappi C, Di Carlo C. Ultrasound prenatal diagnosis of inguinal scrotal hernia and contralateral hydrocele. Case Rep Obstet Gynecol 2013;2013:764579) [54].

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  Fig. 5 Right testis extruding from the scrotum in a 15-day-old newborn, which was confirmed as scrotoschisis (reprinted with permission from Pujar VC, Joshi SS, Singh DR. Scrotoschisis: a rare cause of acute scrotum in neonates. Indian J Urol 2015;31:262–3) [119].

Reference

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