Scrotal calculi in clinical practice and their role in scrotal pain: A prospective study

J Clin Ultrasound. 2015 Sep;43(7):406-11. doi: 10.1002/jcu.22247. Epub 2014 Oct 18.

Abstract

Purpose: Scrotal calculi are rare, and their clinical significance is uncertain. Scrotal pain is a frequent, hard-to-manage problem in urology clinics. Our purpose in this study was to determine the relationship between the presence of scrotal calculi and scrotal pain in a prospective manner.

Methods: Sonography and color Doppler ultrasound of the scrotum were performed in 758 consecutive patients referred with scrotal pain. The pain was rated by using an 11-point numeric rating scale; scores were compared among patients with scrotal calculi with and without additional scrotal pathology.

Results: Scrotal calculi were detected in 73 of the 758 patients (9.6%). Scrotal pain (n = 50 [61%]) and a palpable mass in the scrotum (n = 25 [30.5%]) were the most common complaints in patients with scrotal calculi. Hydrocele (n = 17 [29.8%]) and varicocele (n = 15 [26.3%]) were the most commonly associated abnormalities; there was a statistically significant association between the presence of scrotal calculi and hydrocele (p < 0.01). Scrotal pain was present in 61 (83.5%) patients with scrotal calculi, and this association was significant (p < 0.001). The presence of scrotal pain and the correlation between location of calculi and pain in patients without additional scrotal abnormalities were also significant (p = 0.04 and p < 0.004, respectively).

Conclusions: The prevalence of scrotal calculi was 9.6%, and hydrocele was found to be associated with scrotal calculi. We also found a significant relationship between the presence of calculi and scrotal pain. Because the etiology of scrotal pain is essential for appropriate treatment, scrotal calculi should be kept in mind when making a differential diagnosis of scrotal pain. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:406-411, 2015.

Keywords: calculi; hydrocele; lithiasis; pain; scrotum; ultrasonography.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Calculi / complications*
  • Calculi / diagnostic imaging*
  • Diagnosis, Differential
  • Genital Diseases, Male / complications*
  • Genital Diseases, Male / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnostic imaging
  • Pain / etiology*
  • Prospective Studies
  • Scrotum / diagnostic imaging*
  • Testicular Hydrocele / complications
  • Testicular Hydrocele / diagnostic imaging
  • Ultrasonography, Doppler, Color
  • Varicocele / complications
  • Varicocele / diagnostic imaging
  • Young Adult