GuidelineEuropean radiology2025
The role of the radiologist in the evaluation of male infertility: recommendations of the European Society of Urogenital Radiology-Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for scrotal imaging.
Guideline in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Machine learning of multiparametric MRI radiomics preoperatively distinguishes testicular seminoma from non-seminoma: a multicenter study.Abdominal radiology (New York) · 2026Article
- MRI of the Scrotum and Penis: Current Applications and Clinical Relevance.Diagnostics (Basel, Switzerland) · 2025Review
- The value of ultrasound texture analysis in the diagnosis of pathological types of primary testicular tumours in adults.BMC cancer · 2025Article
- Review
- Recent Trends in the Management of Varicocele.Journal of clinical medicine · 2025Review
- Epidemiology and occupational risk factors of male infertility based on 3,025 patients in Eastern Morocco during 2021-2023: a cohort study.Obstetrics & gynecology science · 2025Article
- Development and Validation of an Ultrasound Imaging Algorithm for Structured Reporting in Testicular Pathology.Diagnostics (Basel, Switzerland) · 2025Article
- Is testicular microlithiasis associated with decreased semen parameters? a systematic review.Basic and clinical andrology · 2024Review
- Beyond the Basics: Best Practices in Scrotal Ultrasound for the Infertile Male.International braz j urol : official journal of the Brazilian Society of UrologyArticle
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15 authors.
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Abstract
objectivesThe Scrotal and Penile Imaging Working Group (SPIWG) of the European Society of Urogenital Radiology (ESUR) aimed to produce recommendations on the role of the radiologist in the evaluation of male infertility focused on scrotal imaging.
methodsThe authors independently performed an extensive literature Medline search and a review of the clinical practice and consensus opinion of experts in the field.
resultsScrotal ultrasound (US) is useful in investigating male infertility. US abnormalities related to abnormal sperm parameters (sperm concentration, total count, motility, and morphology) are low testicular volume (TV), testicular inhomogeneity (TI), cryptorchidism, testicular microlithiasis (TML), high-grade varicocele, bilateral absence of vas deferens, bilateral dilation and echotexture abnormalities of the epididymis. The proposed ESUR-SPIWG recommendations for imaging in the evaluation of male infertility are therefore: to measure TV; investigate TI; perform annual (US) follow-ups up to age 55 in men with a history of cryptorchidism/orchidopexy and/or in men with TML plus "additional risk factors" or with "starry sky" TML; perform scrotal/inguinal US in men with nonpalpable testis; perform scrotal US in men with abnormal sperm parameters to investigate lesions suggestive of tumors; evaluate varicocele in a standardized way; evaluate the presence or absence of vas deferens; investigate the epididymis to detect indirect signs suggesting obstruction and/or inflammation.
conclusionsThe ESUR-SPIWG recommends investigating infertile men with scrotal US focusing on TV, inhomogeneity, localization, varicocele, vas deferens, and epididymal abnormalities. Cryptorchidism, TML, and lesions should be detected in relation to the risk of testicular tumors. CLINICAL RELEVANCE STATEMENT: The ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility are useful to standardize the US examination, focus on US abnormalities most associated with abnormal semen parameters in an evidence-based manner, and provide a standardized report to patients. KEY POINTS: So far, ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility were not available. The ESUR-SPIWG recommends investigating infertile men with scrotal US focusing on testicular volume, inhomogeneity, localization, varicocele, vas deferens and epididymal abnormalities, and assessing cryptorchidism, testicular microlithiasis and lesions in relation to the risk of testicular tumors. The ESUR-SPIWG recommendations on scrotal imaging in the assessment of male infertility are useful to standardize the US examination, focus on US abnormalities most associated with abnormal sperm parameters in an evidence-based manner, and provide a standardized report to patients.
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