{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:16:41Z","timestamp":1785752201066,"version":"3.56.0"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: The aim of this study was to investigate the effectiveness and reliability of point-of-care ultrasonography (POCUS) in the differential diagnosis of azoospermia. Materials and methods: Records of 175 patients who had previously been diagnosed with normal-volume, normal-PH azoospermia and who had undergone surgical sperm retrieval were reviewed retrospectively. Patients\u2019 preoperative evaluations included a comprehensive history and physical examination and a routine scrotal POCUS performed during their initial consultation by a non-radiologist treating andrologist in a clinic setting. Positive scrotal imaging revealed ectasia of the rete testis and\/or dilation of the epididymal ductules. Based on their preoperative assessments, patients were guided to undergo either testicular sperm aspiration (TESA)\/microsurgical sperm aspiration (MESA) procedures for those with suspected obstructive azoospermia (OA) or microdissection testicular sperm extraction (micro-TESE) for those with suspected non-obstructive azoospermia (NOA). Results: Of the 175 patients, 58 patients had normal follicle-stimulating hormone (FSH) levels (\u226412 IU\/L) and normal testicular volume. Thirty of them had no secondary signs of obstruction in their scrotal POCUS and subsequently underwent micro-TESE. All were confirmed to have NOA. Twenty-eight patients demonstrated at least two secondary signs of obstruction on scrotal POCUS. Of these, 15 underwent TESA, and 13 underwent MESA procedures. Twenty-seven patients were confirmed to have OA, and one was confirmed as having NOA. Among this cohort of men, the sensitivity of scrotal POCUS in diagnosing OA was 100%, whereas the specificity was 96.8%. Positive and negative predictive values (PPVs and NPVs) were 96.4 and 100%, respectively. Conclusions: Scrotal POCUS is an effective clinical diagnostic tool for distinguishing obstructive and non-obstructive azoospermia. Being noninvasive, safe, and affordable makes it an ideal bedside clinical tool that can serve the skilled non-radiologist clinician reliably.<\/jats:p>","DOI":"10.3390\/jcm14082837","type":"journal-article","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T20:24:16Z","timestamp":1745180656000},"page":"2837","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Diagnostic Value of Point-of-Care Ultrasonography in the Differential Diagnosis of Azoospermia: Introducing a Concept"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3962-5233","authenticated-orcid":false,"given":"Shlomi","family":"Barak","sequence":"first","affiliation":[{"name":"Reproductive Services-Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod 6134789, Israel"},{"name":"Obstetrics and Gynecology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Netanel","family":"Waldenberg","sequence":"additional","affiliation":[{"name":"The Multidiciplinary Center for Female and Male Infertility, Tel Aviv 6422521, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Bar","sequence":"additional","affiliation":[{"name":"Reproductive Services-Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod 6134789, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oshri","family":"Barel","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod, Israel, Affiliated with the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8031-9684","authenticated-orcid":false,"given":"Snir","family":"Dekalo","sequence":"additional","affiliation":[{"name":"Urology Department, Tel Aviv Sourasky Medical Center, Faculty of Medical Health and Sciences, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.fertnstert.2018.01.043","article-title":"Evaluation of the azoospermic male: A committee opinion","volume":"109","author":"Hwang","year":"2018","journal-title":"Fertil. 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