Scrotum and prostate
a small solid structure located posterior to the epididymal head.
benign prostatic hypertrophy (BPH)
benign enlargement of the prostate gland; noninflammatory condition.
cone-shaped area of the prostate gland located deep in the peripheral zone.
separates the prostate and rectum; important landmark for radical prostatectomy
long, tightly coiled ducts that carry sperm from the testis to the vas deferens.
inflammation of the epididymis; commonly caused by a urinary tract infection; most common cause of acute scrotal pain.
abnormal accumulation of serous fluid between the two layers of tunica vaginalis.
thick portion of the tunica albuginea.
the largest area of the prostate gland located just beneath the capsule.
glandular tissue lining the proximal prostatic urethra.
prostate specific antigen (PSA)
a protein produced by the prostate; elevation is associated with carcinoma of the prostate gland.
inflammation of the testis; commonly caused by Chlamydia.
network of ducts formed in the mediastinum testis connecting the epididymis with the superior portion of the testis.
small paired structures that store sperm.
retropubic space between the symphysis pubis and urinary bladder.
supporting structure on the posterior border of the testes that courses through the inguinal canal.
a cyst arising from the rete testis.
hypoechoic connective tissue dividing the peripheral and central zones.
twisting of the spermatic cord upon itself, obstructing the blood vessels supplying the epididymis and testis; also known as bell clapper.
two small areas of the prostate gland adjacent to the proximal urethral space.
fibrous sheath enclosing each testis.
two layers of serous membrane (visceral and parietal) covering the anterior and lateral portions of the testis and epididymis.
Transurethral Resection Prostatectomy (TURP)
a surgical procedure to relieve symptoms of BPH; demonstrates as an anechoic space in the center of the prostate.
dilatation of the spermatic veins; most common cause of male infertility.
a small tube that transports the sperm from each testis to the prostatic urethra.
Anatomy
Scrotum (fig. 16-1)
• A two-compartment pouch that contains and supports each testis.
• Divided by a medium raphe or septum.
• Contains a number of tissue layers and vascular structures.
Prostate gland (fig. 16-2)
• A cone-shaped retroperitoneal structure.
• Inferior border (apex) provides an exit for the urethra.
• Superior border (base) is in contact with the urinary bladder.
• Consists of five lobes: anterior, middle, posterior, and two lateral lobes.
• Divided into three zones: central, peripheral, and transitional zones.
• Lies inferior to the seminal vesicles and urinary bladder.
• Lies posterior to the symphysis pubis and anterior to the rectal ampulla (space of Retzius).
• Lies anterior to Denonvilliers’ fascia.
• Attached to the symphysis pubis by prostatic ligaments.
• The urethra is the anatomical landmark dividing the prostate into anterior (fibromuscular) and posterior (glandular) sections.
Vascular anatomy
Scrotum
Prostate
Urethral artery
Congenital Anomalies—Scrotum and Prostate
| ANOMALY | DESCRIPTION | CLINICAL FINDINGS | SONOGRAPHIC FINDINGS | DIFFERENTIAL CONSIDERATIONS |
| Cryptorchidism | Undescended testis80% are located in the inguinal canalAssociated with a herniated scrotal sac and an increased risk of infertility, torsion, and malignancyNormal testes will descend by 6 months of age | Absence of testis in the scrotumPalpable inguinal mass | Absence of testis in the scrotumOval-shaped hypoechoic mass in the inguinal canal, pelvis, or retroperitoneumSmaller than a normal testisGenerally mobile | Lymph nodeHematomaBowel |
| Polyorchidism | Presence of more than two testesAssociated with inguinal hernia, testicular torsion, and malignancy | AsymptomaticEnlarged scrotumPalpable scrotal mass | Small echogenic extratesticular mass similar to the testisUsually located in the superior medial aspect of the scrotum | Epididymal neoplasmTesticular neoplasmEpididymitis |
| Agenesis of the seminal vesicles | Absence of seminal vesiclesAssociated with ipsilateral renal agenesis | AsymptomaticUrinary retentionPerirenal pain | Absence of the hypoechoic seminal vesicles | Technical errorUsually located in the superior medial aspect of the scrotumEpididymal neoplasm |
Sonographic appearance
Scrotum
• Thin hyperechoic wall measuring 2 to 8 mm in thickness.
• Small amount of anechoic fluid surrounds each testis.
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