Ultrasound Protocol Library / Scrotal Ultrasound Protocol
Examination protocol
Scrotal Ultrasound Protocol
A bilateral grayscale and Doppler demonstration emphasizing side-to-side comparison, complete survey of the scrotal contents, measurements, and documentation.
Protocol demonstration
Scrotal Ultrasound Examination Protocol
Watch the complete examination once, then repeat it while following the preparation and documentation guide below.
Before the examination
Preparation
- Confirm the indication, symptomatic side, onset and character of symptoms, palpable findings, and relevant surgical or trauma history.
- Select a high-frequency linear transducer and presets suitable for superficial grayscale and low-flow Doppler imaging.
- Position the patient supine with scrotal support, warm gel, appropriate draping, and minimal transducer pressure.
- For suspected torsion or another urgent condition, follow the practice's expedited communication pathway without delaying care.
During the examination
Scanning sequence
- Begin with a side-by-side transverse comparison using identical grayscale and Doppler settings.
- Survey each testis completely in longitudinal and transverse planes and measure as required.
- Evaluate the epididymis, spermatic cord, scrotal wall, extratesticular spaces, and any palpable site.
- Compare vascularity bilaterally; add spectral Doppler, upright positioning, or Valsalva when indicated by the clinical question.
Required record
Images and documentation
- A side-by-side transverse comparison and representative longitudinal and transverse images of each testis.
- Required testicular dimensions or volume and labeled images of the epididymides and relevant extratesticular structures.
- Bilateral color or power Doppler comparison with identical settings, plus spectral waveforms when indicated.
- Each abnormality and the palpable site in two planes, with measurements and appropriate vascular assessment.
Quality review
Common pitfalls
- Using a pulse-repetition frequency or wall filter that is too high to display low flow.
- Changing Doppler settings between sides and then treating the images as a valid comparison.
- Applying excessive pressure that reduces venous flow or causes avoidable discomfort.
- Failing to extend the survey to the spermatic cord or inguinal region when the indication requires it.
Knowledge check
Check your understanding
Answer each question before opening it to compare your response with the teaching point.
Why should both testes be shown together early in the examination?
A side-by-side image provides an immediate comparison of size, echotexture, and vascularity and helps reveal subtle asymmetry.
Which settings are especially important when looking for low flow?
Use an appropriately low pulse-repetition frequency or scale, low wall filter, optimized gain, and minimal transducer pressure while keeping settings comparable between sides.
What should happen if the findings raise concern for torsion?
Complete the essential comparison and documentation without avoidable delay and use the institution's urgent communication pathway immediately.