Prevalence of Testicular Microlithiasis in Males Aged 0 to 18 Years Referred for Scrotal Sonography

Background: Testicular microlithiasis (TM) is a relatively uncommon and usually asymptomatic condition that is characterized by multiple 1-3 mm nonshadowing echogenic foci within the parenchyma of the testis. Objectives: The prevalence of testicular microlithiasis was assessed retrospectively in males ranging from 0-18 years who had been referred for scrotal ultrasound. Materials and Methods: Scrotal ultrasound examinations were performed in males aged 0-18 years old, producing 401 scans in 363 patients. The accumulated data included referring specialist, indication for sonography, consultant radiologist, number of images available for review of the left and right testis, associated anomalies, histological results, and testicular tumor markers. Results: Testicular microlithiasis was found in 21 patients (5.8%). The mean age of the patients with and without testicular microlithiasis was 11.3 and 6.7 years, respectively (P = 0.000). Significantly more images were available for patients with testicular microlithiasis (P = 0.000), yet only 8 of the 21 cases (38.1%) were identified by the consultant radiologists. None of the boys with testicular microlithiasis were found to have a testicular malignancy. Conclusions: our study showed a prevalence of testicular microlithiasis of 5.8% in symptomatic boys. The prevalence seemed to increase with age. Consultant radiologists are advised to be more vigilant towards testicular microlithiasis and to scan and store a sufficient number of imaging planes during ultrasonography.