ARRS Imaging of Pathologies of Male External Genitalia 2025

Advanced Genitourinary Imaging of Penile, Scrotal & Inguinal Pathologies

The ARRS Imaging of Pathologies of Male External Genitalia 2025 course delivers a focused and clinically practical review of diagnostic imaging for disorders affecting the penis, scrotum, testes, and inguinal region. Developed by the American Roentgen Ray Society (ARRS), the program explores both emergency and non-emergency genitourinary imaging scenarios, emphasizing accurate interpretation, differential diagnosis, and imaging-guided clinical triage.

Although male external genital imaging represents a relatively specialized area within radiology, it frequently presents high-stakes diagnostic challenges in emergency medicine, urology, trauma care, oncology, and reproductive medicine. The course addresses these complexities through a case-based and anatomy-driven approach designed to improve confidence in interpreting acute, chronic, traumatic, and neoplastic abnormalities of the male external genitalia.

Released in October 2024, the program reflects current imaging practices and contemporary radiologic approaches to scrotal, penile, and inguinal pathology.

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Course Overview

This online educational course reviews:

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

The lectures integrate:

• Ultrasound interpretation
• Cross-sectional imaging correlation
• Emergency radiology principles
• Urologic surgical relevance
• Imaging-based management decisions

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Why Male External Genital Imaging Matters Clinically

Imaging of the male external genitalia often requires rapid and highly accurate interpretation because diagnostic delays can significantly affect:

• Fertility preservation
• Testicular viability
• Surgical planning
• Infection control
• Trauma management
• Oncologic outcomes

In practice, clinicians and radiologists frequently encounter situations where:

• Physical examination is limited by pain or swelling
• Findings overlap between benign and emergent conditions
• Imaging directly determines surgical urgency
• Rare pathologies mimic common diagnoses

The course appropriately emphasizes that external genital imaging is not simply descriptive anatomy review—it is highly decision-oriented radiology.

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Acute Non-Traumatic Scrotum & Inguinal Pathology

One of the central components of the course involves evaluation of the acute scrotum.

The lectures review differential diagnosis and imaging findings for:

• Epididymitis
• Orchitis
• Testicular torsion
• Torsion-detorsion syndromes
• Hydroceles
• Varicoceles
• Hernias
• Scrotal wall abnormalities
• Extratesticular lesions
• Inguinal pathology

Acute scrotal pain remains one of the more time-sensitive presentations in emergency imaging because delayed diagnosis—particularly in torsion—may result in irreversible ischemic injury and testicular loss.

The course emphasizes careful sonographic assessment and vascular evaluation while also addressing diagnostic pitfalls that may complicate interpretation.

One recurring challenge in practice involves differentiating:

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

The discussions appropriately focus on real-world diagnostic ambiguity rather than oversimplified textbook presentations.

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Penile & Scrotal Trauma Imaging

Traumatic injuries of the male external genitalia are often clinically underrecognized and may involve significant medicolegal and surgical implications.

The trauma-focused lecture reviews:

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

Imaging plays a central role in determining:

• Surgical versus conservative management
• Extent of injury
• Associated vascular damage
• Timing of intervention

In practice, traumatic genital imaging frequently requires balancing subtle imaging findings against potentially serious functional consequences involving:

• Erectile dysfunction
• Fertility impairment
• Chronic pain
• Cosmetic deformity

The course provides practical imaging frameworks that align closely with urologic management priorities.

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Neoplasms of the Male External Genitalia

The neoplasm section reviews imaging findings associated with:

• Testicular tumors
• Penile malignancies
• Benign scrotal masses
• Extratesticular neoplasms
• Metastatic disease
• Rare tumors of the external genitalia

Testicular cancer remains one of the most important malignancies affecting younger male patients, and imaging frequently represents the first major step in diagnosis and staging.

The course explores:

• Sonographic tumor characterization
• Solid versus cystic lesion assessment
• Doppler findings
• Local invasion patterns
• Differential diagnosis of intratesticular masses

Importantly, the faculty emphasize that not all testicular lesions represent malignancy, and imaging interpretation must incorporate:

• Age
• Clinical presentation
• Tumor markers
• Associated inflammatory findings

These nuanced discussions are particularly valuable in avoiding both overdiagnosis and delayed oncologic evaluation.

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Penile Prosthesis Imaging & Complications

Penile prostheses represent an increasingly common intervention in urologic practice, particularly in patients with:

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

The prosthesis lecture reviews:

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

Radiologists increasingly encounter postoperative penile prosthesis imaging in both emergency and outpatient settings, yet many clinicians remain unfamiliar with expected postoperative anatomy.

The course appropriately focuses on distinguishing:

• Normal postoperative findings
  from
• Clinically significant complications requiring intervention

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Differential Diagnosis & Imaging Strategy

A major educational strength of the course is its emphasis on differential diagnosis.

Rather than presenting isolated pathology examples alone, the lectures repeatedly explore:

• Overlapping imaging appearances
• Mimickers of emergent disease
• Pitfalls in Doppler interpretation
• Appropriate imaging sequencing
• Correlation with clinical findings

Male genital imaging often requires thoughtful integration of:

• Ultrasound
• CT
• MRI
• Clinical examination
• Laboratory findings
• Surgical context

This multimodality perspective enhances the course’s real-world applicability for practicing radiologists and trainees alike.

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Educational Approach

The course combines:

• Case-based radiology teaching
• High-yield imaging review
• GU anatomy correlation
• Emergency imaging principles
• Urologic management relevance
• Practical differential diagnosis frameworks

Faculty lectures include:

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

all contributing focused expertise in genitourinary imaging and emergency radiology.

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What’s Included

• Acute scrotal imaging review
• Penile trauma interpretation
• Testicular and penile neoplasm imaging
• Penile prosthesis anatomy and complications
• Differential diagnosis frameworks
• Ultrasound-focused GU radiology education
• Emergency and outpatient imaging applications

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Why This GU Imaging Course Matters

Imaging of the male external genitalia remains one of the more technically nuanced and clinically sensitive areas in genitourinary radiology. Accurate interpretation directly affects emergency management, fertility preservation, oncologic diagnosis, surgical planning, and long-term functional outcomes.

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