Cryptorchidism and the value of ultrasonography

The aim of this study was to evaluate the usefulness and accuracy of ultrasonography in investigating cryptorchidism.

Case notes were reviewed of all children with cryptorchidism who had undergone ultrasonography for their testes between February and October 2010. Preoperative ultrasonography findings for presence or absence and position of testes were noted and compared with the operative findings. The sensitivity and specificity of ultrasonography were calculated.

A total of 50 testes in 42 boys were examined by ultrasonography preoperatively during the study period. The median age was 6 years. All had single B-mode greyscale ultrasonography using greyscale and Doppler imaging. Of the 50 testes, 42 were visualised intracanalicularly or in the superficial inguinal pouch, 2 were intra-abdominal and 6 could not be detected. However, on examination under anaesthesia, 37 out of the 50 testes were palpable in the groin and 13 were impalpable. Two out of the remaining thirteen were found to be atrophic on diagnostic laparoscopy. The sensitivity and specificity of ultrasonography in determining the presence of testes was 85% and 25% respectively.

Ultrasonography has low sensitivity and specificity in determining the presence of testes and localisation of their position. When performing an examination under anaesthesia and using a laparoscopic technique, ultrasonography is not recommended in cases of cryptorchidism.