A varicocele means there is enlargement of the veins in the scrotum caused by stasis of blood flow. The stasis can cause blood to pool in the vessel until the vessel wall begins to bulge, and the scrotal sac swells. Though it may appear earlier, a varicocele usually develops around the age of 15 (puberty) and often occurs on the left side.
If your son has a varicocele, he may not experience any pain or swelling, except perhaps during physical exercise. While bathing, he might notice a large vein in his scrotum, or that one testis is smaller than the other. Varicoceles are sometimes discovered during routine physical examinations.
If a varicocele is found during a physical examination by your child’s primary care physician, your child will be referred to a pediatric urologist. Your Nemours urologist will do a comprehensive evaluation of your child’s condition, including a physical examination and medical history.
If there’s concern about the size of the testis, your doctor will order a scrotal/testicular ultrasound. Based on this test, the doctor will discuss treatment and therapy options for your child.
If your son isn’t experiencing pain or discomfort, the recommendation may be to closely monitor growth and development of the testes as he goes through puberty.
If there is a significant difference in the size of the two testes, or if your son is experiencing pain, then surgical correction may be indicated. Nemours urologists can usually do this as an outpatient procedure, and in a few weeks your son can get back to normal activities.
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Ultrasound: Renal (Kidneys, Ureters, Bladder)
What It Is
A renal ultrasound is a safe and painless test that uses sound waves to make images of the kidneys, ureters, and bladder.
The kidneys are a pair of bean-shaped organs located toward the back of the abdominal cavity, just above the waist. They remove waste products from the blood and produce urine. The ureters are thin tubes that carry the urine from the kidneys to the bladder.
During the examination, an ultrasound machine sends sound waves into the kidney area and images are recorded on a computer. The black-and-white images show the internal structure of the kidneys and related organs.
Why It's Done
Doctors order renal ultrasounds when there's a concern about certain types of kidney or bladder problems. Renal ultrasound tests can show:
- the size of the kidneys
- signs of injury to the kidneys
- abnormalities present since birth
- the presence of blockages or kidney stones
- complications of a urinary tract infection (UTI)
- cysts or tumors
Usually, you don't have to do anything special to prepare for a renal ultrasound, although the doctor may ask that your child not eat or drink anything for several hours before the test. Sometimes a renal ultrasound needs a child to have a full bladder; in this case, the doctor will give specific instructions on what to do.
You should tell the technician about any medicines your child is taking before the test begins.
The renal ultrasound will be done in the radiology department of a hospital or in a radiology center. Parents are usually able to accompany their child to provide reassurance and support. Your child will be asked to change into a cloth gown and lie on a table. The room is usually dark so the images can be seen clearly on the computer screen.
A technician (sonographer) trained in ultrasound imaging will spread a clear, warm gel on your child's abdomen over the kidney area. This gel helps with the transmission of the sound waves. The technician will then move a small wand (transducer) over the gel. The transducer emits high-frequency sound waves and a computer measures how the sound waves bounce back from inside the body. The computer changes those sound waves into images to be analyzed.
Sometimes a doctor will come in at the end of the test to meet your child and take a few more pictures. The procedure usually takes less than 30 minutes.
What to Expect
The renal ultrasound test is painless. Your child may feel a slight pressure on the abdomen as the transducer is moved over it. You'll need to tell your child to lie still during the procedure so the sound waves can reach the area effectively. The technician may ask your child to lie in different positions or hold his or her breath briefly.
Babies might cry in the ultrasound room, especially if they're restrained, but this won't interfere with the procedure.
Getting the Results
A radiologist (a doctor who is specially trained in reading and interpreting X-ray and ultrasound images) will interpret the ultrasound results and then give the information to the doctor. You and your doctor will go over the results. If the test results appear abnormal, your doctor may order further tests.
In an emergency, the results of an ultrasound can be available within a short period of time. Otherwise, results are usually ready in 1-2 days. In most cases, results can't be given directly to the patient or family at the time of the test.
No risks are associated with a renal ultrasound. Unlike X-rays, radiation isn't involved with this test.
Helping Your Child
Some younger children may be afraid of the machinery used for the ultrasound test. Explaining in simple terms how the renal ultrasound test will be conducted and why it's being done can help ease your child's fears. You can tell your child that the equipment takes pictures of his or her kidneys.
Encourage your child to ask the technician questions and to try to relax during the procedure, as tense muscles can make it more difficult to get accurate results.
If You Have Questions
If you have questions about the renal ultrasound, speak with your doctor. You can also talk to the technician before the exam.
Reviewed by: Rupal Christine Gupta, MD
Date reviewed: September 26, 2016