Testicular Microlithiasis, Long Term Experience of a Single Institution

Abstract

Introduction: Several studies have reported an association between testicular microlithiasis (TML) and testicular malignancy with some suggesting the concordance to be as high as 40%. In 2000, we published a large study of 4819 patients referred for scrotal ultrasound (USS) at four referral centers. Based on our findings we recommended ultrasound surveillance of patients with TML. The aim of this study was to determine the long-term outcome of our surveillance regimen. Methods: We reviewed the prospective database of all men diagnosed with TML at USS between 1996 and 2006 at our institution. All patients diagnosed with TML were scheduled for six-monthly USS and in addition they were given instructions to perform regular self-examination. Fifteen years after the surveillance program was commenced, all patients were contacted and asked to complete a short questionnaire. Results: 57 men were diagnosed with TML with no concurrent or previous testicular tumour. The mean period of follow up was 28.4 months (3–102). Only one man developed testicular cancer during the follow up period. Conclusions: We currently recommend regular testicular self-examination of all men with TML and reserve USS surveillance for selected patients with associated risk factors for testicular malignancy.