Association Between Testicular Microlithiasis and Ultrasound-based Testicular Volume in Pediatric Population

Objective: A potential relationship between testicular microlithiasis (TM) and testicular atrophy in childhood might increase the risk of testicular malignancy and infertility in adulthood. The present study aimed to determine the effect of the presence of TM on testicular volume by comparing the ultrasound-based testicular volumes between boys with TM and controls. Method: A total of 140 boys (mean +- standard deviation, 9.86 years +- 5.44 years; age range, 0-18 years) with two descended testes were classified into a study group of 70 patients with TM (TM group) and an age-matched control group of 70 boys without TM (non-TM group). The TM group was subdivided based on the number of microliths in one transducer field as ‘mild TM' (5-20 microliths) and ‘severe TM' (>20 microliths). The ultrasound-based testicular volume (mL) was estimated by the Lambert equation as 0.71× length × width × depth. Results: The average testicular volume in the TM group was 1.44 (0.70-4.68) mL and 3.09 (0.84-14.65) mL in the non-TM group. A lower testicular volume was observed in patients with TM, however, this difference was not significant (p=0.096). The average testicular volumes in patients with ‘severe TM' and ‘mild TM' were not significantly different (p=0.106). A lower testicular volume was found in older boys (≥15 years) with ‘severe TM'. Conclusion: We found no significant association in the testicular volume between boys with TM and controls, however, a lower testicular volume was observed in boys with TM. Thus, a close clinical follow-up might be considered in these patients.