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Context: There are orchidometer-based testicular volume nomograms for Indian children; however, accurate and reliable values measured by ultrasound are lacking. Aims: The aim of this study was to (1) measure the testicular volumes of boys from birth to 8 years and generate reference values and (2) to identify factors if any that may influence variation in testicular volumes. Settings and Design: This was a prospective observational study conducted on 320 children in the Department of Pediatric Surgery, Christian Medical College, Vellore, India. Subjects and Methods: A total of 320 boys without any genital abnormalities were studied. The testes were scanned using a linear transducer, and the length, width, and depth of each testis were recorded. Testicular volume was calculated using Lambert's equation - length x width x depth x 0.71. Statistical Analysis Used: Mean testicular volumes and standard deviation for every year of age were calculated. The centile values for testicular volume were computed using R software. Results: Age-specific nomogram of each testis was created separately. Interobserver variability of the measurement was shown to be up to 0.3 ml. No difference was demonstrated in the testicular volumes between the right and left testis. No correlation was found between body weight and body mass index with testicular volume. From the data on differences in size between the two sides, a volume differential index of 27% corresponds to the 95th centile. Conclusions: Reference values have been created for testicular volumes in prepubertal Indian children that could be used to assess the effects of disease and surgical interventions in this age group. [ABSTRACT FROM AUTHOR]

Context: Measuring testicular volume (TV) by orchidometer is the standard method of male pubertal staging. A paucity of evidence exists as to its inter‐ and intra‐observer reliability and the impact of clinicians' gender, training and experience on accuracy. Objective: Prosthetic testicular models were engineered to investigate accuracy and reliability of TV estimation. Design: Simulation study. Setting: Conducted over three‐day 2015 British Society for Paediatric Endocrinology and Diabetes (BSPED) meeting. Participants: Two hundred fifteen meeting delegates (161F, 54M): 50% consultants, 30% trainees, 9% clinical nurse specialists, 11% other professionals. Intervention: Three child‐sized mannequins displayed latex scrotum containing prosthetic testicles of 3, 4, 5, 10 and 20 mL. Demographic data, paediatric endocrinology experience, TV examination training, examination technique and TV estimations were collected. Delegates were asked to repeat their measurements later during the meeting. Scrotum order was changed daily. Main outcome measures: Accuracy by variance from the simulated TV. Inter‐ and intra‐observer variability. Results: One thousand two hundred eighty four individual estimations were obtained. Eighty‐five participants repeated measurements. Delegates measured TV accurately on 33.4% (±2.6) of occasions: overestimations 37% (±2.3), underestimations 28% (±1.8) (Fleiss' Kappa score 0.04). The accuracy of assessing a 4 mL testis was 36%‐39%. Observers underestimated the volume when paired with a 3 mL testis and overestimated when paired with a 5 mL testis demonstrating a tendency impose biological symmetry. Intra‐observer reliability was lacking; individuals giving different estimations for the same size testicle on 61% (±4.2) of occasions, 20% (±3.5) of estimations were more than 1 size outside the previous measurement. On only 39% (±4.2) of occasions did individuals agree with their previous estimation (irrespective of whether or not it was initially accurate). Training did not impact on results but experience did improve accuracy. Conclusions: Overall TV estimation accuracy was poor. Considerable variation exists between and within subjects. Seniority slightly improved measurement estimation. [ABSTRACT FROM AUTHOR]

Background: Prader orchidometry has been the standard method for evaluating testicular size. As this technique is subjective and tends to overestimate the testicular volume, ultrasound (US) has been proposed as more reliable.Objective: To evaluate the intra- and interobserver agreement of US measurements of testicular volume and to compare US with the Prader orchidometer.Materials and Methods: Dimensions of the right testicle were measured using US in 57 boys ages 6.5 to 16.4 years (mean: 12.0 years). The measurements were performed twice by one main observer and once by a second observer. A third observer estimated testicular volume using a Prader orchidometer. Agreement was investigated with Bland-Altman plots, summarized as the mean and standard deviation (SD) of differences, 95% limits of agreement and technical error of measurement.Results: Mean intra-observer difference of testicular volume was 2.2%, SD=9.2% (limits of agreement: -20.3 to 15.9%) and technical error of measurement 6.5%. The mean interobserver difference was 4.8%, SD=20.7% (limits of agreement: -35.7 to 45.3%) and technical error of measurement 14.6%. Comparing US and orchidometer volumes required conversion that was nonlinear and volume dependent, estimated as VolOM = 1.96×VolUS0.71. The mean difference after transformation was 0.7% with an SD of 18.0% (limits of agreement: -34.5 to 35.9%).Conclusion: Our results showed a small mean intra- and interobserver difference that indicates the potential of US for measurement of testicular volume at group level. The intra-observer error was limited, which justifies its use in longitudinal follow-up of testicular development in an individual child, but the larger interobserver variability indicates the need for good standardization of methods. Agreement between the two methods requires a power transformation. [ABSTRACT FROM AUTHOR]

Aim Accurate calculations of testicular volume standard deviation ( SD) scores are not currently available. We constructed LMS-smoothed age-reference charts for testicular volume in healthy boys. Methods The LMS method was used to calculate reference data, based on testicular volumes from ultrasonography and Prader orchidometer of 769 healthy Dutch boys aged 6 months to 19 years. We also explored the association between testicular growth and pubic hair development, and data were compared to orchidometric testicular volumes from the 1997 Dutch nationwide growth study. Results The LMS-smoothed reference charts showed that no revision of the definition of normal onset of male puberty - from nine to 14 years of age - was warranted. In healthy boys, the pubic hair stage SD scores corresponded with testicular volume SD scores (r = 0.394). However, testes were relatively small for pubic hair stage in Klinefelter's syndrome and relatively large in immunoglobulin superfamily member 1 deficiency syndrome. Conclusion The age-corrected SD scores for testicular volume will aid in the diagnosis and follow-up of abnormalities in the timing and progression of male puberty and in research evaluations. The SD scores can be compared with pubic hair SD scores to identify discrepancies between cell functions that result in relative microorchidism or macroorchidism. [ABSTRACT FROM AUTHOR]

Background: Self-assessment of puberty has been reported to correlate well with staging by a physician. No previous study has evaluated the use of an orchidometer to assess testicular size in boys. Study design: This study included 44 girls and 56 boys, 10-16 years old, with assessed Tanner staging. The boys also used an orchidometer. The correlation with a professional's staging was analyzed using percentage agreement (PA). Results: For girls, the PA for breast development was 52%, and for pubic hair, 64%. There was no case of the difference being greater than one stage. For boys, the PA for pubic hair was 75%. For testicular volume, the PA was 36%; in 95%, the difference was only one size. Conclusions: We found pubertal self-assessment, including the use of an orchidometer for boys, to be a useful method. However, if the purpose is to determine exact pubertal onset, the assessment should be made by a trained professional. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography (US) to determine the critical testicular volume indicating normal testicular function by each method. Methods: Total testicular volume (right plus left testicular volume) was measured in 794 testes in 397 men with infertility (mean age, 35.6 years) using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length × width × height × 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results: Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion: Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. [ABSTRACT FROM AUTHOR]

Aim: To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function. Methods: We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators (andrological career: 4–21 years) from five institutions and 12 male volunteers aged 20–26 years. Testicular volume was measured by Prader's orchidometer. A skilled technician also performed an ultrasound estimate of testicular volume. Results: A statistically significant inter-investigator variation was found for both testes ( P < 0.05). In addition, there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement ( P < 0.01). However, there was no statistically significant difference in the two measurements performed on consecutive days for either testis. The testicular volumes for both the right and left testes as estimated by ultrasonog-raphy were smaller than results using the orchidometer. However, there was no statistical significance ( P > 0.05). The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis. Conclusion: The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators, but intra-investigator variation was not considerable. Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination. [ABSTRACT FROM AUTHOR]

Measurement of testicular volume is a more readily available method of estimating spermatogenesis in adolescence. Traditionally, testicular volumes have been measured with different type of orchidometers or calipers. The most widely used orchidometer is the Prader orchidometer introduced in 1966. This type of orchidometer, a graded series of ellipsoid beads on a string, is used for testicular volume measurement, which is a useful index of puberty in male in order to evaluate male growth and development. Although it is more practical and inexpensive compared with ultrasonography, this instrument has been questioned in regard to its objectiveness in different hands. We designed a prospective clinical study to investigate the correlation between testicular size measurements of three different clinical investigators by using Prader orchidometer. A total of 100 testes in 50 boys with a mean age of 6.4 years (range 1–15 years) who presented to Urology and Pediatrics outpatient clinics of our hospital without urogenital complaints were enrolled to this study. The volumes of each testis were measured independently using Prader orchidometer by three different clinical investigators (A, B and C). Each investigator repeated testicular volume measurements blinded to measurements obtained by others. The measured volumes were recorded separately. Statistical analysis of the results was performed using Pearson’s correlation ( r) to determine the correlation of orchidometer measurements between the examiners. All statistical analyses and power calculations were performed using computer software. Mean testicular volumes measured by three examiners A, B and C were 4.01±3.79 ml (SD) (2–18 ml), 3.66±3.46 ml (SD) (1–18 ml) and 3.86±3.54 ml (SD) (1–18 ml), respectively. The statistical correlation between the measurements of investigator A and B, A and C, and B and C showed a high correlation { r=0.954 ( P<0.01), r=0.964 ( P<0.01), and r=0.979 ( P<0.01)}, respectively. In the present study, it was shown that testicular size measurement by using Prader orchidometer gives good correlation in different examiners’ hands and it is an objective and reliable method in pediatric urological practice. [ABSTRACT FROM AUTHOR]

To determine the limitations of a punched-out orchidometer in practical use, we compared with a scrotal ultrasound (USG).A total of 281 testes from 142 males were examined using both a punched-out orchidometer and a USG. The volume differential between both methods was calculated and expressed as orchidometer/USG volume (O/U ratio). Distribution of the O/U ratio was determined and subdivided by clinical or pathological diagnosis. The correlations between the O/U ratio and patient age or orchidometer results were assessed.There was a significant linear relationship between the results of orchidometer and USG (r= 0.94,P<0.0001). The relationship between the O/U ratio and age or testicular volumes showed significant inverse correlations (r= 0.22,P= 0.0002,r= 0.45,P<0.0001, respectively). Klinefelter's syndrome, ipsilateral detorted testes and hypogonadotropic hypogonadism comparatively showed a high O/U ratio. No incidental lesion was detected by USG necessitating treatment.The punched-out orchidometer gives estimates that correlated well with the USG measurements and provides enough information for routine andrological evaluation. We should be aware that the orchidometer often overestimates the testicular volume, especially for the patients with small testis or adolescents.(Asian J Androl 2005 Mar; 7: 77–80) [ABSTRACT FROM AUTHOR]

To determine the correlation between testicular volume measured with an orchidometer or high-resolution scrotal ultrasonography (US) with colour-flow Doppler analysis. Orchidometer estimates of testicular volume correlate closely and very significantly with US estimates in adults. In the hands of an experienced examiner orchidometer measurements provide an accurate, rapid and inexpensive assessment of testicular volume. [ABSTRACT FROM AUTHOR]