Does scrotal ultrasound reduce the need for orchidectomy in the clinically malignant testis?

Many recent studies have confirmed the ability of ultrasound to elucidate scrotal pathology, but its place in the work-up of specific testicular problems is not yet fully defined. We investigated 15 cases where a firm clinical diagnosis of testicular malignancy was made. All cases progressed to orchidectomy. Scrotal ultrasound refuted the diagnosis of malignancy in seven cases with subsequent histological proof of benignity. However, the nature and extent of the benign disease was such that, on review, orchidectomy was considered to be the most appropriate method of treating the patient. We contend that in the case of firm clinical diagnosis of testicular malignancy, an ultrasound diagnosis of benignity will not alter management, and it is therefore not an essential part of the work-up in this group of patients.

What is the clinical significance of urethroprostatic reflux as a radiological finding during videocystourethrography in neurologically normal patients?

The video records of 264 males referred for videocystometry were reviewed retrospectively for evidence of urethroprostatic reflux. This was found in 11% of the cases with three distinct patterns; during bladder filling (27%); during voiding (50%), and during the 'stop test' (23%). All cases with filling reflux were unstable. Reflux at the time of the stop test was usually associated with prostatic or bladder neck obstruction. Voiding reflux occurred in a similar group of patients but there was often a clinical history of the previous surgical relief of obstruction or documented urinary infections. Recognition of this sign suggests the transmission of high pressures to the prostatic urethra and contrary to previous work is uncommonly associated with a history of lower urinary tract pain in cases where it may otherwise go unexplained.