Doppler ultrasonography in the diagnosis of acute scrotal pain

Pre-operative Doppler ultrasonography was performed on 41 patients who underwent an emergency scrotal exploration because of the clinical suspicion of a testicular torsion. The final diagnoses were testicular torsion in 18 patients, epididymitis in 15 patients and torsion of a testicular appendage in 8 patients. An unequivocal indication as to the presence or absence of a testicular torsion was obtained in 31 patients (76 per cent), an equivocal result was obtained in 5 patients and in 5 patients the examination was unsatisfactory. The sensitivity and specificity of the investigation for the diagnosis of testicular torsion were 67 per cent and 83 per cent respectively, and the predictive value of either a positive or negative result was 100 per cent. Our results suggest that the use of Doppler ultrasonography could reduce the incidence of unnecessary operations without incurring the risk of reduced testicular salvage.