Rajiv, Paul Mukha (2009) Assessment of Testicular Volume: How Accurate is it? Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : The testicle (from Latin testicular, diminutive of testis, meaning "witness" [of virility]) is the male generative gland. The testis is a vital endocrine and reproductive organ. As well as semen and endocrinological analyses, the evaluation of testicular size is an initial and important method for estimating spermatogenesis and for monitoring the changes in pubertal status to optimize the treatment selection. Testicular volume has traditionally been assessed using orchidometers. The orchidometers over the years have been modified, refined and compared to each other. With the advent of Ultrasound, which is non invasive and patient friendly a new technique for the evaluation of testicular size came into being. We strive to look at the various techniques of testicular measurement and arrive at the most effective way of measurement of the human testes. AIMS: The aim of this study was to assess the accuracy of orchidometer and sonographic testicular volume assessment in comparison to true volume assessment in the Indian population. Determine the average testicular volume in the Indian adult male. Objectives: 1. Comparison of testicular volumes as calculated using, 2. Ultrasound, 3. Prader orchidometer, 4. Water displacement method. 5. To arrive at an appropriate correction factor to be applied to sonographic measurement to improve the accuracy of in situ assessment of testicular volume. 6. To calculate the density of the human testes. 7. Determine the average testicular volume in the Indian adult male in the population studied. MATERIALS AND METHODS: This study was conducted on patients with advanced carcinoma prostate who were scheduled to have bilateral orchidectomy as part of hormone ablation. All men who opted for bilateral orchidectomy instead of medical castration were part of this study. Men with conditions like hydrocoeles, filarial scrotums, prior scrotal surgery, hernias, varicoceles and any other condition altering the anatomy of the scrotum or the testis were excluded from the study. All patients were explained the nature of the study and an informed consent in the patients own language was obtained. The study design and methodology was approved by the Ethics Committee and the Institutional Review Board. The patients underwent a preoperative assessment by the Prader orchidometer by a single urologist. In a warm room with adequate privacy after explaining the procedure, the scrotal skin was stretched and size of the testis determined by comparison to the Prader orchidometer. The ellipsoid best matching the actual testicular volume was taken as the correct measurement. Subsequently, sonographic assessment of testicular volume was performed by a single radiologist, who was blinded to the earlier measurements. The testis was scanned with an ultrasound imaging machine (Siemens Antares, Germany) using both high and low frequency linear array transducers (7.5 – 10 MHz). Scanning was performed by using light pressure to avoid distortion of the testicular shape. At least three separate transverse and longitudinal images of each testicle were obtained with both transducers. The three largest volumes were averaged and used for calculation and comparison. RESULTS: There were a total of fifty five patients with patients with 110 testes. The mean age of the patients was 65. 6 years, the range being ninety to forty eight years. The maximum number of subjects was between the age group 55 – 60 years. DISCUSSION: Our study showed the mean testicular volume by the Prader orchidometer to be 19.5 ml (range 10 – 25 ml). The average testicular volume on sonography was 14.6 ml with a range of 7.3 – 23.0 ml. The average volume by the water displacement method was 14.45 ml, (range 7.6 – 22.0 ml). There was little difference in the mean volume between the two sides when measured by the Prader orchidometer – right being 20 ml and left being 19.09 ml. This difference in sides was more pronounced in the case of the mean volume measured on sonography, right - 15.1 ml and left - 13.7 ml. The least difference between the two sides was by the water displacement method, right - 14.6 ml and left 14.3 ml. CONCLUSIONS This study shows that the ultrasound is more reliable than the Prader orchidometer. The testicular measurements on ultrasound are nearly as accurate as those by the water displacement method. The Prader orchidometer appears to overestimate the size of the testis. We recommend that the ultrasound be used to measure testicular volume in all cases with abnormalities of testicular function.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Testicular Volume ; Assessment ; Accurate. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 12 Oct 2017 01:17 |
| Last Modified: | 12 Oct 2017 01:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3466 |
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