Obligatory medical device diagnostics.
- Scrotal sonography (examination of scrotal organs testis and epididymis by ultrasound) [testicular size (difference > 20% or 2 ml)?, venous covolate?, testicular tumor?]
- Varicocele [collection of echo-poor structures with anechoic borders; pathologic (pathological): vein diameter > 3.5 mm]Note: For diagnosis and classification of varicocele, Doppler sonography (ultrasound examination) is the appropriate procedure; this allows acoustic visualization of venous return[Doppler sonography: the diagnosis is considered confirmed if at least two veins with a lumen of more than 3 mm and flow reversal with or without valsalva maneuver are detectable].
- Hydrocele (hydrocele) [anechoic peritesticular space; it may be completely anechoic or, in the case of a very large hydrocele, it may have a chambered structure with septa]
- Spermatocele (usually located on the epididymis retention cyst containing sperm-containing fluid) [typical is the anechoic or low-echoic cystic space, which originates from the epididymis].
- Abdominal ultrasonography (ultrasound of abdominal organs): renal ultrasonography – if symptomatic varicocele (retroperitoneal tumor?) is suspected.
- Spermiogram (sperm examination) – in the context of infertility or fertility diagnostics [up to 55% of men with a varicocele grade III have a pathological spermiogram].
- Thermography of the scrotal skin (measurement of the body surface temperature of the scrotum) [positive finding: about 0.6-0.8° Celsius higher temperature in the congestion area]
- Diaphanoscopy (fluoroscopy of body parts through an attached light source; here: Scrotum (scrotum)) – to distinguish scrotal hernia (testicular hernia) and hydrocele.
Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)/magnetic resonance imaging (MRI) – only in the case of inconclusive findings.