Interpreting Your Testicular Ultrasound Results
Your report uses clinical terminology that may be unfamiliar. A consultant sonographer explains what each term means, what the common findings are, and what action — if any — is required.
- Men's Health
- Updated July 2026
Key Terms in Your Report
| Term | What It Means | Clinical Significance |
|---|---|---|
| Homogeneous echotexture | Uniform, even internal texture — normal testicular appearance | Normal finding |
| Heterogeneous echotexture | Non-uniform, mixed internal texture | Abnormal — may indicate tumour, infarction, or orchitis |
| Hypoechoic | Darker than surrounding tissue | Classic appearance of testicular tumour; also seen in orchitis |
| Hyperechoic | Brighter than surrounding tissue | Microcalcifications; scar tissue |
| Anechoic | No internal echoes — appears completely dark | Fluid — cysts, hydrocele (usually benign) |
| Increased vascularity | More blood flow than expected on Doppler | Infection/inflammation (orchitis) or malignancy |
| Absent/reduced vascularity | Less blood flow than expected on Doppler | Possible torsion (if acute pain) or infarction |
| Microlithiasis | Multiple small calcifications (<3mm) within the testicular parenchyma | Requires annual self-examination; follow-up if risk factors present |
| Varicocele | Dilated pampiniform plexus veins (>3mm) | Associated with subfertility; urology referral if symptomatic |
| Hydrocele | Fluid collection surrounding the testis | Usually benign; large or complex hydroceles may need urology review |
| Epididymal cyst / spermatocele | Benign fluid-filled cyst in the epididymis head | Benign; no treatment needed |
Common Findings and What They Mean
"Bilateral epididymal cysts noted. No intratesticular lesion identified."
This is a normal, reassuring report. Epididymal cysts are benign fluid-filled structures in the epididymis — the coiled tube behind the testis. They are very common, require no treatment, and do not become cancerous. The key phrase is "no intratesticular lesion identified" — this means no abnormality was found within the testis itself.
"Right-sided varicocele identified. No intratesticular lesion."
A varicocele is an enlargement of the pampiniform plexus veins in the scrotum — similar to varicose veins in the leg. It is present in approximately 15% of men. Most varicoceles cause no symptoms and require no treatment. If you are having a fertility investigation, a varicocele is relevant — it is the most common correctable cause of male subfertility and can be treated surgically or by embolisation.
"Hypoechoic intratesticular lesion identified. Urgent urology referral recommended."
This is the finding that requires immediate action. A hypoechoic solid mass within the testicular parenchyma is treated as testicular cancer until proven otherwise. This does not mean it is definitely cancer — but it means the clinical pathway that follows (urology referral, tumour markers, possible orchidectomy) needs to begin the same day. If you have received this report from Sonoworld, you will have been told this clearly in the room and given a referral letter.
"Features consistent with epididymo-orchitis."
Epididymo-orchitis is infection or inflammation of the epididymis and/or testis. On ultrasound, it appears as an enlarged, hypervascular (increased blood flow) epididymis, sometimes with involvement of the testis itself. Treatment is with antibiotics prescribed by your GP. See your GP the same day with this report.
From Our Practice
The most common question after a testicular ultrasound is: "What does this mean for me?" The answer depends entirely on what the scan found. For the majority of patients — those with epididymal cysts, hydroceles, or varicoceles — the answer is straightforward: the finding is benign, requires no treatment, and the symptom that prompted the scan has been explained. For the smaller proportion of patients with a finding that requires further action, the answer is equally clear: here is what was found, here is what it means, and here is exactly what needs to happen next.
The written report is designed to be read by both the patient and the receiving clinician. It uses standardised terminology, documents all measurements, and concludes with a clear clinical recommendation. If you have questions about your report that were not answered in the verbal explanation at the time of the scan, you can contact us directly.
Observations above are drawn from composite patterns across our patient population, not from any individual case.
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