Imaging of prostatic and testicular disorders

Ultrasound is playing an increasingly important role in the evaluation of testicular and prostatic abnormalities. It provides differentiation of intratesticular lesions, which are most likely malignant, from extratesticular lesions, which are usually benign. Duplex sonography enables accurate rapid diagnosis of testicular torsion and distinction between this and epididymo-orchitis. Ultrasound can also be used to evaluate the traumatised testis. Ultrasound has some advantages over IVP for assessment of the renal tracts and prostate in patients with prostatism. The development of transrectal ultrasound enables better evaluation of the prostate gland than has been previously possible and enables ultrasound-guided transrectal biopsies of prostatic lesions to detect early prostatic carcinoma. TRUS is likely to play an increasing role in evaluation of the prostate as it becomes more readily available. Other imaging modalities have a role in specific circumstances as outlined.