小结
定义
病史和体格检查
关键诊断因素
- presence of risk factors
- painless scrotal mass
- left-sided signs/symptoms
- small testicle
其他诊断因素
- infertility
- age over 12 years
- scrotal or groin pain
危险因素
- somatometric parameters (tall/low BMI)
- family history of varicocele
诊断性检查
首要检查
- clinical diagnosis
需考虑的检查
- scrotal ultrasound with colour flow Doppler imaging
- semen analysis
- serum FSH (± GnRH stimulation)
- serum testosterone
- DNA fragmentation index (DFI)
- CT abdomen/pelvis
- MRI abdomen/pelvis
- retroperitoneal ultrasound
治疗流程
adolescent
adult
撰稿人
作者
Jay Ira Sandlow, MD
Professor and Chair
Department of Urology
Medical College of Wisconsin
Milwaukee
WI
利益声明
JIS declares that he has received stock options as a member of the Scientific Advisory Board for Contraline, Inc. and has served as a faculty member on the Vasectomy course for the American Urological Association.
Daniel L. Pelzman, MD
Fellow in Male Reproductive and Sexual Health
Department of Urology
Medical College of Wisconsin
Milwaukee
WI
利益声明
DLP declares that he has no competing interests.
鸣谢
Dr Jay Ira Sandlow and Dr Daniel L. Pelzman would like to gratefully acknowledge Dr Jagan K. Kansal, Dr Pravin Rao, Dr Miguel Pineda, Dr John C. Thomas, and Dr Wayne Kuang, previous contributors to this topic.
利益声明
JKK, PR, MP, JCT, and WK declare that they have no competing interests.
同行评议者
Siam Oottamasathien, MD
Assistant Professor
Division of Pediatric Urology
University of Utah
Primary Children's Medical Center
Salt Lake City
UT
利益声明
SO declares that she has no competing interests.
Jeffrey Donohoe, MD
Assistant Professor
Pediatric Urology
Medical College of Georgia
Augusta
GA
利益声明
JD declares that he has no competing interests.
Daniel H. Williams, MD
Assistant Professor
Department of Urology
Head
Section of Male Infertility and Andrology
University of Wisconsin School of Medicine and Public Health
Madison
WI
Disclosures
DHW declares that he has no competing interests.
Edmund Sabanegh, Jr, MD
Director
Center for Male Fertility
Glickman Urological and Kidney Institute
Cleveland
OH
Disclosures
ES declares that he has no competing interests.
Differentials
- Paratesticular mass
- Cord hydrocele
- Inguinal hernia
More DifferentialsGuidelines
- Guidelines on paediatric urology
- Sexual and reproductive health: male infertility
More GuidelinesPatient information
Fertility problems: some reasons
Fertility problems: what treatments work?
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer