Scrotal Ultrasound


A scrotal ultrasound looks at internal issues that could affect sperm production or quality.

Some possible sources of male infertility problems are minor issues with medication or stress that are often fairly easy to correct with the right adjustments or treatments. Yet, some possible reasons for an inability to conceive can be more difficult to detect or determine. Initial evaluations typically involve a physical exam and semen analysis.

However, if results are inconclusive or there could be other contributing factors, a scrotal ultrasound may be done to look for possible structural problems within the sac that holds the testicles.

What Is a Scrotal Ultrasound?

A scrotal ultrasound is a type of image test that uses high-frequency sound waves to produce images of internal structures in a way that’s more detailed than what’s provided by X-rays. It’s done to look at the scrotum and supporting structures, including the testicles located within this pouch. The resulting images can also identify varicoceles (enlarged or enlarged scrotum veins) and other issues that could be affecting sperm quality and production.

How Do You Prepare for It?

Men are typically asked to wear loose-fitting clothing that can be easily removed to access the pelvic area to perform the ultrasound. A gown may also be worn. There are no other specific preparation requirements.


What Happens During the Ultrasound?

During a scrotal ultrasound, gel is placed directly on the outer skin of the scrotum. A handheld probe (transducer) that’s similar to a microphone in appearance is placed over the gelled area to produce real-time images that are viewed on a monitor. You’ll be lying face-up on an examination table during the process. You may be gently moved to different positions so a better view of tissues and structures in the scrotum can be seen. There may be some slight discomfort if the probe is moved over a part of the scrotum that’s particularly sensitive. Otherwise, there is usually no pain.

What Specifically Will Be Viewed?

Because the ultrasound images are live, the flow of blood through the vessels in the scrotum and testicles can be viewed to identify possible reasons for infertility issues. Since there are many possible causes of fertility problems, the probe may be moved over all areas of the scrotum to view both testicles and nearby tissues in as much detail as possible to look for any abnormalities. This imaging technique may also be used to look for:

  • Signs of an unusual mass in the scrotum
  • Anything that suggests trauma or damage to tissues or structures
  • Evidence of any abnormal internal swelling or inflammation
  • Testicles that are irregularly shaped

If a scrotal ultrasound shows abnormal testicle size or shape or structural irregularities with tubes that carry sperm, a testicular biopsy may be done to determine if sperm production is normal. If enlarged scrotal veins are found, laparoscopic or open surgery may be done to restore normal blood flow in veins. A related procedure referred to as a transrectal ultrasound might be performed to evaluate the prostate and nearby ejaculatory ducts and seminal vesicles. Even if diagnostic testing doesn’t pinpoint a clear reason for male infertility, there are several treatment options that may lead to conception.