Testicular Ultrasound: The Complete Guide
What the scan involves, what it can find, how to prepare, and how to read your report — a consultant sonographer explains everything you need to know before your testicular ultrasound.
- Men's Health
- Updated July 2026
What Is a Testicular Ultrasound?
A testicular ultrasound (also called a scrotal ultrasound) is a non-invasive imaging investigation that uses high-frequency sound waves to produce real-time images of the testes, epididymides, and surrounding scrotal structures. It is the first-line imaging modality for any scrotal symptom — a lump, pain, swelling, or change in size — and provides information that clinical examination alone cannot.
At Sonoworld, testicular ultrasound is performed using a high-frequency linear probe (12–15 MHz) that provides detailed greyscale images of the testicular parenchyma alongside colour Doppler assessment of blood flow. The combination of greyscale and Doppler is essential: greyscale identifies structural abnormalities; Doppler distinguishes between conditions that look similar on greyscale but require different management (for example, epididymo-orchitis, which shows increased flow, versus testicular torsion, which shows absent or reduced flow).
How to Prepare
No special preparation is required for a testicular ultrasound. You do not need to fast, have a full bladder, or avoid any medications. Wear comfortable, loose clothing. The scan is performed with you lying on an examination couch; the sonographer will provide a towel to keep you comfortable during the procedure.
What Happens During the Scan
The scan takes approximately 20 minutes. Warm ultrasound gel is applied to the scrotal skin, and a small probe is moved gently over the surface. There are no needles, no compression, and no instruments inserted into the body. The procedure is painless in the vast majority of cases; if there is pre-existing tenderness, the sonographer will adjust the pressure accordingly.
Both testes and epididymides are assessed systematically — size, volume, echotexture, and any focal lesion. Colour Doppler is applied to both sides to compare blood flow. The sonographer will explain what they are looking at as the scan progresses and will give you a verbal summary of findings immediately after the scan.
What the Scan Can Find
| Finding | What It Means | Action |
|---|---|---|
| Epididymal cyst / spermatocele | Benign fluid-filled cyst in the epididymis | Reassurance; no treatment needed |
| Hydrocele | Fluid collection surrounding the testis | Usually benign; large or complex hydroceles may need urology review |
| Varicocele | Dilated pampiniform plexus veins | May affect fertility; urology referral if symptomatic or fertility concern |
| Epididymo-orchitis | Infection/inflammation of epididymis ± testis | GP for antibiotic treatment |
| Testicular microlithiasis | Multiple small calcifications in testicular parenchyma | Annual self-examination; follow-up if risk factors present |
| Solid intratesticular mass | Testicular tumour until proven otherwise | Same-day urology referral |
| Absent Doppler flow | Possible testicular torsion (if acute pain) | Immediate A&E attendance |
How to Read Your Report
The Sonoworld testicular ultrasound report documents: testicular dimensions (length, width, depth, and volume for each testis), echotexture (homogeneous = normal; heterogeneous = abnormal), any focal lesion (location, size, echogenicity, vascularity), epididymal findings, extratesticular findings (hydrocele, varicocele), and Doppler assessment. The report concludes with a clinical impression and recommendation.
Key terms to know:
- Hypoechoic: Darker than the surrounding tissue on ultrasound. A hypoechoic intratesticular lesion is the classic appearance of a testicular tumour.
- Hyperechoic: Brighter than the surrounding tissue. Microcalcifications appear hyperechoic.
- Anechoic: No internal echoes — appears completely dark. Cysts and fluid collections are anechoic.
- Heterogeneous: Non-uniform internal texture — a mix of echogenicities. Abnormal in the testis.
- Vascularity: Blood flow detected on Doppler. Increased vascularity in a focal lesion raises concern for malignancy or infection.
For a full explanation of your specific findings, see: Interpreting Your Testicular Ultrasound Results
From Our Practice
The question patients ask most often before a testicular ultrasound is: "What are you actually looking for?" The honest answer is that we are looking for a solid mass within the testicular parenchyma — a finding that would require urgent onward referral. Everything else — cysts, hydroceles, varicoceles, inflammation — is a finding that can be explained, contextualised, and managed without urgency. The scan is designed to answer the most important question first, and then to characterise whatever else is present.
The second most common question is: "Will I know the result today?" Yes. Verbal results are given in the room immediately after the scan. The written report is sent the same day. There is no waiting for a GP appointment to find out what the scan found.
Observations above are drawn from composite patterns across our patient population, not from any individual case.
Testicular Ultrasound FAQs
Is a testicular ultrasound the same as a scrotal ultrasound?
Yes. The terms are used interchangeably. A scrotal ultrasound assesses all structures within the scrotum — both testes, both epididymides, and the surrounding scrotal wall and fluid. A testicular ultrasound refers to the same investigation.
How accurate is testicular ultrasound?
Scrotal ultrasound has a sensitivity of approximately 95% and specificity of 95–99% for detecting testicular tumours. It is the definitive imaging investigation for scrotal pathology and is more accurate than clinical examination alone for characterising the nature of a scrotal finding.
Book a Testicular Ultrasound Scan
£235 · Same-day appointments · No GP referral needed · Verbal results in the room · Written report the same day
29 Weymouth Street, Marylebone, London W1G 7DB | 020 3633 4902
