Testicular Microlithiasis: Prevalence and Clinical Significance in a Population Referred for Scrotal Ultrasonography

TLDR

Testicular microlithiasis (TM) is an uncommon condition detected by scrotal ultrasonography and has been suggested to increase the risk of testicular cancer and infertility, prompting a retrospective review of 1,439 ultrasound examinations. The study retrospectively examined 1,439 scrotal ultrasounds, identified 87 TM cases, and assessed their association with pathology, graded TM relative to cancer, and performed semen analyses in infertile patients. In this cohort, TM was present in 6.0% of men and was significantly associated with testicular cancer and infertility, yet no difference in cancer prevalence across TM grades or in seminal parameters was observed, indicating that TM grading does not influence cancer detection or semen quality.

Abstract

Testicular microlithiasis (TM) is an uncommon pathologic condition that is commonly diagnosed by scrotal ultrasonography. Indirect evidence suggests that this syndrome may be associated with an increased risk of testicular malignancy and infertility.A total of 1,439 patients undergoing scrotal ultrasound during a 6-year, 5-month period (January 2003 to May 2009) were retrospectively reviewed. Any possible association of TM with pathologic findings was assessed. Among patients with TM, further grading of TM with testicular cancer and semen analysis of the infertile group with TM were also performed.TM was diagnosed in 87 patients (6.0%) out of a total of 1,439. Of all established pathologic entities, only testicular malignancy and infertility were meaningfully associated with TM. There was no significant difference in the prevalence of testicular cancer between each grade. Seminal profiles (sperm count, motility, morphology, and white blood cell count) were not found to be statistically different between infertile men with and without TM.The prevalence of TM in symptomatic men was found to be 6.0% with significant co-occurrence of TM, testicular cancer, and infertility. Further grading of TM does not seem to be essential with regard to the detection of patients with testicular cancer and TM. TM showed no significant effect on the seminal profiles of infertile men.