Contribution of Doppler Ultrasound in the Evaluation of Scrotal Pain and Swelling

Ambroise Seme Engoumou, Maggy Mbede, Armel Awana, Amadou Idi, Achille Aurele Mbassi, Landry Mbouche, Odile Fernande Zeh

Abstract


ABSTRACT
Introduction. Scrotal swelling and pain are frequently encountered in clinical practice. Although in some patients, history and physical examination are adequate to reach a diagnosis, yet in a large percentage of patients, additional studies are required for complete evaluation of their symptoms. Color Doppler examination of scrotum has been demonstrated to have significant impact on diagnosis of scrotal swelling. Our study was aimed to evaluate how Doppler Ultrasound (DU) can be effective in the evaluation of scrotal pain and swelling, in characterizing, and its management. Methodology. This was a cross-sectional descriptive study on patient who presented on consultation with acute scrotal pain, swelling. The study was carried out in Yaounde at the Yaounde Central Hospital and the Yaounde Gyneco Obstetric and Pediatric Hospital in the Urology and Radiology departments. The study lasted seven 7 months. Results. One hundred and fifty-two (152) patients were enrolled. Their ages ranged from 4 to 75 years with a mean age of 34.83±13.78 years with the most occurring age group between 15-30 age with n=56 (36.08%). The Cohen kappa correlation test between clinical findings and DU findings showed the following results: almost perfect agreement for testicular torsion (0.959) and epididymo-orchitis (0.93); substantial agreement for varicocele (0.788) and fair agreement for normal testes (0.597). DU had a sensitivity (Se) of 92.9% and specificity (Sp) of 100% in the diagnosis of testicular torsion. The values for other pathologies were epididymo-orchitis (Se 100%, Sp 99.3%); varicocele (Se 92.9%, Sp 96%); normal testes (Se 68.6%, Sp 96%); microlithiasis and epididymal cyst (Se 100% and Sp 100%). Conclusion. Doppler Ultrasound is effective in the evaluation of scrotal pain and swelling.
RÉSUMÉ
Introduction. La tuméfaction et la douleur du scrotum représentent un motif de consultation fréquent en urologie. L’objectif de ce travail était d’évaluer l’efficacité de l'échographie Doppler dans l'exploration de la douleur et la tuméfaction scrotales. Méthodologie: Il s'agissait d'une étude transversale descriptive réalisée dans deux hôpitaux universitaires de Yaoundé au Cameroun. Elle portait sur tous les patients qui présentaient une douleur scrotale et une tuméfaction. Les données ont été collectées à l'aide d'un formulaire de collecte de données préétabli. L'analyse statistique a été effectuée à l'aide de la version 20 de SPSS et de la version 3.54 d'Epi-Info pour Windows. Le coefficient de corrélation, la sensibilité et la spécificité de l’échographie doppler ont été calculées pour les principales pathologies. Résultats. Nous avons recruté 152 patients. Leur âge variait entre 4 et 75. Tous les patients se plaignaient de douleur scrotale alors que 78 (51,30%) présentaient une tuméfaction scrotale. Le diagnostic clinique le plus fréquent était les varicocèles n = 119 (78,3%). Les diagnostics échographiques les plus fréquents étaient : hydrocèle n = 150 (98,70%) ; varicocèles n = 127 (83,60%) et microlithiases épididymaires n = 39 (25,70%). Le test de corrélation de Cohen kappa a montré une bonne concordance entre les résultats cliniques et les résultats de l'échographie Doppler. La sensibilité et la spécificité échographique étaient excellentes dans la détection des torsions testiculaires, des orchi-épididymites, des varicocèles, des microlithiases testiculaires, des hydrocèles, et des kystes épididymaires. Conclusion. L'échographie Doppler est efficace dans l'évaluation de la douleur et de la tuméfaction scrotale.


Keywords


scrotal swelling, scrotal pain, Doppler Ultrasound, Yaoundé, Cameroon.

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