Question of the Week
For July 28, 2015
A 30-year-old man presents with a progressively enlarging left-sided scrotal mass, which he first noticed several weeks ago and describes as nontender but slightly uncomfortable.
On physical examination, the patient’s vital signs are normal. Head, neck, cardiovascular, and respiratory examination findings are within normal limits, and an abdominal examination is unremarkable. Examination of the scrotum reveals a left-sided varicocele, with a classic “bag-of-worms” feel on palpation. It is equally present in both the standing and the supine position.
What is the most appropriate next diagnostic step in this case?