Scrotal scanning is a nuclear procedure performed to assist in diagnosing diseases and disorders of the testis, epididymis, spermatic cord, and other contents of the scrotal sac. An IV injection of 99mTc as technetium Tc 99m pertechnetate is administered, and perfusion and tissue studies are conducted. Based on an increased radionuclide activity and flow, arterial and venous supply, torsion, infections, and tumor abnormalities can be imaged.

• Normal blood flow and structures of scrotal contents; no tumor, hematoma, infection or inflammation, or torsion

• Inability of client to remain still during the procedure, especially if the client is a child

• Unexplained testicular pain and swelling to determine the cause
• Determining infectious processes and differentiating between epididymitis and orchitis as revealed by increased flow and focal increase of the radionuclide
• Diagnosing hydrocele or varicocele as revealed by radionuclide concentration, depending on the size
• Diagnosing torsion abnormalities as revealed by absence of perfusion on the affected side and decreased activity of the radionuclide in the tissue of the affected side when compared with the unaffected side
• Evaluating the effects of trauma such as hematoma or hematocele as revealed by diffuse increase of flow
• Determining the existence and placement of inguinal hernia as revealed by intake extending from the inguinal region to the scrotum
• Diagnosing benign and malignant tumors of the testes as revealed by diffuse increased uptake with some decreased areas

Nursing Care Before the Procedure

Client teaching and physical preparation are the same as for any nuclear scan study (see section under "Brain Scanning").

• Inform the client that the study takes 30 to 60 minutes. A child should be accompanied by the parent of the child's choice.
• History should include information about the reproductive system and signs and symptoms associated with disorders of the scrotum and its contents.

The client is placed on the examining table in a supine position. Potassium perchlorate is administered orally to block thyroid uptake of the radionuclide. The penis is taped in a position over the pubis. If needed, a sling or towel is used to support the scrotum and the scrotum is positioned in the field of the scanner. The client is requested to remain still during the scanning. Imaging is performed initially without a lead shield; then a lead shield is positioned and imaging is repeated. The radiopharmaceutical is administered IV and flow study imaging is performed for 60 seconds at 3- to 6-second intervals. Delayed imaging is then performed to scan the scrotum and activity of the sac contents.⁶⁴

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any nuclear scan study (see section under "Brain Scanning").