Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
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The Authors present their experience on 24 blunt scrotal traumas observed since January 1991. They underline the importance of an ecographic scanning that enables a precise evaluation of the traumatic event. Patients that present positive ultrasonic findings are promptly operated thus permitting bleeding and infection control. ⋯ The diagnostic approach is presented, cases reported and results discussed. After a review of the literature on the topic they stress the role of Eco-Color-Doppler examination in scrotal blunt trauma for the intrinsic characteristics of precision, rapidity and non invasivity. This permits a nosologic evaluation of all types of blunt trauma and selects, for surgery, only those patients with a well definied diagnosis.
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If a varicocele is appreciated on the clinical examination, its presence may then be confirmed by Doppler examination. A pencil-probe Doppler stethoscope is utilized with ultrasonic conduction gel. The patient is examined in the upright position, and conducting medium is applied to the upper aspect of the scrotum. ⋯ Venography is employed for the diagnosis of varicoceles only for patients in whom physical examination and Doppler studies are equivocal but highly suggestive of the presence of a varicocele. In that situation, rather than subjecting the patient to an unnecessary surgical procedure, venography may be employed to confirm the varicocele. Nowadays another diagnostic procedure is successfully used, that consists in a color ultrasound of the scrotum associated with Doppler velocimetry of the spermatic cord.