Prevalence and management of testicular incidentaloma in men with male factor infertility: Experience of a high-volume tertiary center

Background: Testicular lesions most frequently present as palpable testicular masses. Interestingly, the identification of impalpable small testicular masses in patients with male factor infertility is occurring increasingly frequently, most probably due to the widespread use of testicular ultrasonography. In this study, we aim to provide insight into the likelihood of small incidentally found testicular masses and the recommended primary management. Materials and Methods: This is a retrospective study of 2680 infertile men with evidence of testicular lesion <2 cm incidentally found on ultrasound during infertility evaluation. Results: A total of 20/2680 (0.74%) of patients had an intraoperative frozen section due to an incidental testicular lesion. Eighty percent (16/20) found out to be Leydig cell hyperplasia, 15% were Leydig cell benign tumors, and 5% were benign hemangioma. Conclusion: Reassurance and observation are recommended for the small (<2 cm) incidental testicular lesion found during male infertility evaluation.