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PubMed1990

[Diagnostic screening of varicocele: role of echography and Doppler examination in our experience with 216 cases of primary varicocele].

We compared two non-invasive methods to evaluate primary varicoceles: ultrasonography and Doppler examination. We submitted to ultrasonography and Doppler 216 patients, 147 of them were treated by sclerotherapy and 69 by surgery. All ultrasonographic studies were performed by means of a real-time equipment (7.5 Mhz transducer), while Doppler examination was performed with continuous wave equipment. Ultrasonographic findings are reliable for testicular morphology. Doppler examination is useful to evaluate reversed flow. In 4.1% of cases ultrasonography did not agree with the Doppler examination.

Humans↗
PubMed1988

[Clinical studies of varicocele. 3: A rare venous return via Santorini's plexus in a varicocele patient. Report of a case].

A 12-year-old man was referred to our clinic because of sanguineous discharge. At the out-patient department, bilateral varicocele was found. Urinalysis showed microscopic hematuria, but no other laboratory data were abnormal. Excretion urography was normal. The retrograde phlebograph showed a rare venous return via Santorini's plexus and lumbar veins. After varicocelectomy, urinalysis improved.

Child↗
PubMed1995

The aberrantly fed varicocele: frequency, venographic appearance, and results of transcatheter embolization.

OBJECTIVE: Retrograde flow in the internal spermatic vein, which is characteristic of varicocele, can occur despite competent valves because of the presence of bypassing anastomoses. The resulting condition has been called aberrantly fed varicocele. The purpose of this study was to determine the frequency of aberrantly fed varicocele, to analyze its various venographic appearances, and to review the results of attempted embolotherapy. SUBJECTS AND METHODS: We performed left-sided (n = 213) and/or right-sided (n = 121) spermatic venography in 213 patients who were examined for infertility (n = 179), for physical complaints of their varicocele (n = 17), or for varicocele impeding testicular growth (n = 17). The resulting 334 venograms were subdivided as negative or positive for varicocele, and positive venograms were further classified as showing normally or aberrantly fed varicoceles. The aberrantly fed varicoceles were classified according to the sites of the bypassed competent valves and the levels at which the bypassing anastomoses joined the internal spermatic veins. The technical success rate of 192 attempted embolizations of normally and aberrantly fed varicoceles was determined. RESULTS: Of the left-sided spermatic venograms, 42 (20%) were negative and 171 (80%) were positive for varicoceles, which in turn consisted of 125 normally and 30 (19%) aberrantly fed varicoceles (16 could not be classified). On the right side, 78 (64%) venograms were negative and 43 (36%) were positive for varicoceles, consisting of 34 normally and seven (17%) aberrantly fed varicoceles (two were not classified). Venographic classification showed that about half of the cases were in patients with competent orificial valves, which were bypassed by anastomoses joining the internal spermatic veins in their cranial lumbar subsegments. Competent valves lower down were seen only on the left side, and anastomoses joining the internal spermatic veins in their cranial pelvic subsegments occurred relatively more frequently on the right side. Coil embolization was attempted in 118 left-sided and 32 right-sided normally fed varicoceles and in 30 left-sided and seven right-sided aberrantly fed varicoceles. The technical success rate was 97% for left- and right-sided normally fed varicoceles and 73% for left-sided and 57% for right-sided aberrantly fed varicoceles. CONCLUSION: Aberrantly fed varicoceles are found in 17-19% of patients examined with spermatic venography. Coil embolization of aberrantly fed varicoceles is usually successful, but not as reliably as with normally fed varicoceles.

Adolescent↗
PubMed2006

Effects of epidermal growth factor on sperm content and motility of rats with surgically induced varicoceles.

AIM: To investigate the effect of epidermal growth factor (EGF) on the sperm content and motility of the varicocelized rats. METHODS: Forty-eight male Wistar rats were randomly divided into five groups. Experimental varicocele was induced by partial ligation of the left renal vein in the varicocele, the varicocele repair, the varicocele with EGF and the varicocele repair with EGF groups, whereas the control group only received a sham induction of varicocele. Surgical repair of varicocele was performed 4 months later in the varicocele repair and varicocele repair with EGF groups. EGF administration was performed daily by s.c. injection in the varicocele with EGF and varicocele repair with EGF groups at the dose of 10 microg/(kg.day) from the next day of the second surgery. One month later, all animals were killed and bilateral cauda epididymal sperm counts and motility were evaluated. RESULTS: The mean sperm count and percentage of motile spermatozoa were significantly higher bilaterally in the varicocele with EGF group than in the varicocele group (P < 0.05). They were also significantly higher bilaterally in the varicocele repair with EGF group than in the varicocele repair and the varicocele with EGF groups (P < 0.05). CONCLUSION: EGF can improve bilateral epididymal sperm content and motility of the rat with surgically induced varicocele. The administration of EGF in combination with surgical repair is more effective than surgical repair or EGF administration alone. EGF might be useful for the treatment of infertility induced by varicocele.

Animals↗
PubMed2006

The relationship between varicoceles and obesity.

PURPOSE: To determine if a relationship between weight and varicocele occurrence exists, the prevalence of varicoceles was determined in a population of patients presenting with infertility. MATERIALS AND METHODS: Records of 3,213 males presenting with infertility were examined. Patients underwent physical examinations for varicocele presence and grade. Body mass index was calculated. Patients were categorized as normal weight, overweight and obese using National Institutes of Health criteria. Means were compared with Student's t test. Frequencies were compared by chi-square analysis and statistical significance was considered at p < 0.05. RESULTS: A total of 1,093 (34%) patients had varicoceles. The mean body mass index of those without varicoceles was 28.5 (+/- 5.6) kg/cm2, which was greater than the body mass index of those with varicoceles (26.7 [+/- 4.0] kg/cm2) (p < 0.001). Varicocele frequency was calculated for each body mass index group. In the normal weight group (body mass index less than 25) 378 of 884 patients (43%) had varicoceles. In the overweight group (body mass index 25 to less than 30) 540 of 1,549 patients (35%) had varicoceles. In the obese group (body mass index 30 or greater) 175 of 780 patients (22%) had varicoceles (p < 0.001). Analysis comparing varicocele frequency based on varicocele grade per body mass index group was performed. Prevalence of varicocele decreased with increasing body mass index for all varicocele grades (p < 0.001). CONCLUSIONS: Prevalence of varicocele decreases with increasing body mass index. One explanation is increased adipose tissue preventing compression of the left renal vein. Another explanation is decreased detection due to adipose tissue in the spermatic cord. The decrease in varicocele prevalence as a function of body mass index regardless of varicocele grade suggests this explanation is less likely.

Body Mass Index↗
PubMed2003

Reliability of venous diameter in the diagnosis of subclinical varicocele.

OBJECTIVE: The diameters of the veins in the pampiniform plexus have been used to diagnose subclinical varicocele. But there are many cutoff points and some controversies about the diagnosis. These cause difficulty in the evaluation of the results of epidemiological and clinical studies. Our aim is to establish the reliability of vein diameters in the pampiniform plexus in the diagnosis of subclinical varicocele. METHODS: Physical examination, scrotal gray scale ultrasonography (SU) and color Doppler ultrasonography (CDU) were performed to assess varicocele in 100 infertile patients without clinical varicocele (group I), 100 infertile patients with clinical left varicocele (group II), and 50 fertile men without clinical varicocele (group III) as a control group. The diameter of the veins in the pampiniform plexus was measured with SU. According to various cutoff points of venous diameter and CDU criteria, the diagnosis of varicocele was made. The highest mean venous diameters were calculated with and without varicocele in men whose diagnoses had been made with CDU. The results were correlated with each other and the control group. RESULTS: According to venous diameter cutoff points, the varicocele ratio did not correlate with the CDU results (p < 0.05) except for the left side of patients with clinical left-sided varicocele. The highest mean diameters of the veins in group III (control group) did not show a significant difference to the other groups (p > 0.05) except for the left side of group II patients. We did not find an exact relation between the highest venous diameter in the men who have and those who do not have subclinical varicocele with CDU. The highest mean diameter was 2.17 +/- 0.34 (SD) mm for men who have subclinical varicocele and 2.00 +/- 0.31 mm for men who do not have subclinical varicocele by CDU (p < 0.05). CONCLUSION: Our results indicate that venous diameters should not be used as diagnostic criteria for subclinical varicocele. Only the evaluation of venous diameter in varicocele should be used to document and quantify pathology, but it should not be used to establish the diagnosis.

Adult↗