ABSTRACT

This chapter focuses on the role of ultrasound imaging in the infertile male. Infertility is estimated to affect up to 15% of couples, with a male factor present in 50% of cases either as a sole or contributing factor. Assessment of the infertile male involves history taking and genital examination. In addition to laboratory tests, imaging modalities may be helpful in establishing the underlying cause and assisting in treatment. The seminal vesicles are paired elongated, saccular structures, with a homogenous hypoechoic pattern, lying posterior to the bladder and above the prostate. Although 75% of patients with unilateral seminal vesicle cysts may have an absent kidney, this is usually associated with an ectopic ureter draining in the seminal vesicle. Secondary varicocele is a rare finding, secondary to abdominal pathology such as renal cell tumors infiltrating the renal vein, retroperitoneal tumors, and retroperitoneal fibrosis compressing the renal vein and portal hypertension because of abnormal venous communication.