ARRS Imaging of Pathologies of Male External Genitalia 2025

Advanced Genitourinary Imaging of Penile, Scrotal & Inguinal Disorders

Imaging of the male external genitalia remains one of the more specialized yet clinically important areas within genitourinary radiology. Acute scrotal pain, penile trauma, testicular masses, inguinal pathology, and penile prosthesis complications often require rapid and highly accurate interpretation because imaging findings may directly determine emergency surgical intervention, fertility preservation, oncologic management, and long-term functional outcomes.

The ARRS Imaging of Pathologies of Male External Genitalia 2025 online course delivers a focused and clinically practical review of contemporary imaging approaches for disorders affecting the penis, testes, scrotum, and inguinal region. Released in October 2024 by the American Roentgen Ray Society (ARRS), the course combines anatomy-based teaching, case-driven imaging interpretation, and real-world differential diagnosis strategies relevant to emergency radiology, urology, and diagnostic imaging practice.

Rather than presenting isolated textbook examples alone, the course emphasizes the operational role of imaging in triage, diagnosis, surgical planning, and complication assessment.

---

Course Overview

This focused online radiology course reviews:

• Acute non-traumatic scrotal pathology
• Extratesticular and inguinal abnormalities
• Penile and scrotal trauma
• Testicular and penile neoplasms
• Penile prosthesis anatomy
• Prosthesis-related complications
• Differential diagnosis in GU imaging

The lectures integrate:

• Ultrasound interpretation
• Doppler vascular assessment
• Cross-sectional imaging correlation
• Emergency imaging principles
• Urologic surgical relevance
• Practical diagnostic reasoning

---

Male External Genital Imaging Requires Rapid Clinical Decision-Making

Unlike many routine imaging studies, scrotal and penile imaging frequently involves time-sensitive clinical scenarios where delayed interpretation may significantly affect:

• Testicular viability
• Fertility outcomes
• Surgical timing
• Infection control
• Erectile function
• Oncologic staging

In practice, radiologists often encounter cases where:

• Physical examination is limited by pain or swelling
• Clinical findings overlap between benign and emergent disease
• Doppler findings are subtle or equivocal
• Imaging directly determines operative urgency

The course appropriately frames male genital imaging as highly management-oriented radiology rather than purely descriptive anatomy review.

---

Acute Non-Traumatic Scrotum & Inguinal Pathology

The course begins with detailed reviews of acute non-traumatic scrotal and inguinal disorders.

Topics include:

• Epididymitis
• Orchitis
• Testicular torsion
• Torsion-detorsion syndromes
• Hydroceles
• Varicoceles
• Inguinal hernias
• Extratesticular masses
• Scrotal wall abnormalities

Acute scrotal pain remains one of the most urgent diagnostic scenarios in genitourinary imaging because missed or delayed torsion diagnosis can result in irreversible ischemic injury.

The lectures emphasize:

• Doppler ultrasound interpretation
• Vascular flow assessment
• Common imaging pitfalls
• Differential diagnosis frameworks
• Surgical triage considerations

One recurring challenge in practice involves differentiating:

• Early torsion
• Intermittent torsion
• Severe inflammatory hyperemia
• Chronic post-inflammatory changes
• Reactive vascular findings

The discussions appropriately focus on nuanced imaging interpretation rather than oversimplified pattern recognition alone.

---

Extratesticular & Inguinal Lesions

Extratesticular and inguinal pathology often presents diagnostic complexity because imaging findings may overlap significantly between benign and clinically important disease.

The course reviews:

• Spermatic cord lesions
• Scrotal wall pathology
• Inguinal masses
• Hernia-related abnormalities
• Benign cystic lesions
• Inflammatory conditions

These discussions are particularly valuable because many extratesticular findings are incidentally discovered and require careful differentiation from malignant or surgically urgent pathology.

The lectures repeatedly emphasize the importance of correlating:

• Imaging morphology
• Vascularity
• Clinical presentation
• Patient age
• Symptom progression

when developing differential diagnoses.

---

Penile & Scrotal Trauma Imaging

Traumatic injuries of the male external genitalia often require rapid diagnosis to preserve long-term functional outcomes.

The trauma-focused module reviews:

• Penile fracture
• Tunica albuginea disruption
• Corporal injury
• Hematoma characterization
• Testicular rupture
• Scrotal trauma
• Vascular injury
• Post-traumatic complications

Imaging plays a central role in determining:

• Conservative versus surgical management
• Extent of injury
• Urgency of intervention
• Long-term reconstruction planning

In practice, traumatic genital imaging can be particularly challenging because:

• Findings may initially appear subtle
• Soft tissue swelling obscures anatomy
• Patients may delay presentation
• Functional consequences are significant

The course appropriately focuses on identifying imaging findings that should immediately alter management.

---

Neoplasms of the Male External Genitalia

The neoplasm module reviews imaging findings associated with:

• Testicular tumors
• Penile malignancies
• Benign testicular lesions
• Extratesticular neoplasms
• Metastatic disease

Testicular cancer remains one of the most important malignancies affecting younger men, making early imaging recognition especially critical.

The lectures explore:

• Ultrasound tumor characterization
• Intratesticular versus extratesticular differentiation
• Doppler vascular patterns
• Local invasion assessment
• Differential diagnosis of testicular masses

Importantly, the course emphasizes that not all solid testicular lesions are malignant and that accurate imaging interpretation must integrate:

• Patient age
• Tumor markers
• Clinical symptoms
• Associated inflammatory findings

This balanced diagnostic approach helps avoid both unnecessary alarm and delayed oncologic evaluation.

---

Penile Prosthesis Imaging & Complications

Penile prostheses are increasingly encountered in imaging practice due to expanding treatment of:

• Erectile dysfunction
• Post-prostatectomy dysfunction
• Diabetes-related vascular disease
• Peyronie disease

The prosthesis-focused lecture reviews:

• Normal penile prosthesis anatomy
• Cylinder positioning
• Reservoir evaluation
• Device malfunction
• Mechanical complications
• Erosion
• Infection
• Postoperative imaging assessment

Many radiologists encounter prosthesis imaging infrequently, making familiarity with expected postoperative anatomy particularly important.

The course carefully differentiates:

• Normal device appearance
  from
• Clinically significant complications requiring intervention.

---

Practical Differential Diagnosis in GU Imaging

One of the strongest aspects of the course is its emphasis on differential diagnosis and imaging reasoning.

Rather than teaching isolated pathology recognition alone, the faculty repeatedly address:

• Mimics of emergent disease
• Doppler interpretation pitfalls
• Appropriate imaging sequencing
• Multimodality correlation
• Urologic management implications

This practical structure mirrors the realities of emergency and outpatient GU imaging where diagnostic certainty is not always immediate.

---

Faculty & Educational Structure

The course combines:

• Case-based radiology review
• High-yield GU imaging teaching
• Emergency radiology principles
• Ultrasound interpretation
• Surgical relevance discussions
• Practical imaging algorithms

Featured faculty include:

• Paul Nikolaidis
• Helena Gabriel
• Yashant Aswani
• Mark Sugi
• Sadhna Verma

with lectures covering:

• Acute scrotal pathology
• Penile trauma
• GU neoplasms
• Prosthesis complications
• Inguinal pathology

---

Topics Included

• Nontraumatic Acute Scrotum and Extratesticular and Inguinal Pathology – Part 1
• Nontraumatic Acute Scrotum and Extratesticular and Inguinal Pathology – Part 2
• Penile Prosthesis: Complications of Cylinders
• Neoplasms of the Male External Genitalia
• Traumatic Abnormalities of Male External Genitalia

---

Why This GU Imaging Course Matters

Male external genital imaging represents a uniquely sensitive and high-stakes area of radiology where accurate interpretation directly influences emergency intervention, oncologic diagnosis, fertility preservation, and long-term functional outcomes.

The ARRS Imaging of Pathologies of Male External Genitalia 2025 course provides a focused, clinically relevant, and case-driven review of contemporary GU imaging through practical discussions tailored to real-world radiology and urologic practice. For radiologists, urologists, emergency physicians, and trainees seeking greater confidence in penile and scrotal imaging interpretation, the course offers a highly valuable and specialized educational resource.