No abstract available.
Diagnosis* ; Ultrasonography* ; Varicocele*

In order to consider the usefulness of radioisotope in diagnosing varicocele, a study was performed on 124 cases. Among them, 74 cases were diagnosed as varicocele, which included 16 cases of subclinical varicocele. Among 74 varicocele patients, 62 cases ( 83.8%) were diagnosed by varicocele index and 59 cases (79.7% ) were diagnosed by static image. A combination of the above two methods allowed 67 cases (90.5 %) to be diagnosed. 21 patients who had a high ligation of internal spermatic vein showed 11 excellent results, 6 good results and 4 poor results. Out of 10 patients with subclinical varicocele, there were 6 excellent results, 3 good results and 1 poor result and 9 patients showed improvement on postoperative semen analysis. There was no significant statistical difference in frequency of the testicular arterial insufficiency between the small varicocele group and the large varicocele group. Also, through scrotogram, it became known that semen analysis proved little help in aiding the diagnose of subclinical varicocele. In conclusion, 'Scrotogram proved very helpful in diagnosis and judging the results of operations of varicocele including subclinical varicocele.
Diagnosis ; Humans ; Ligation ; Semen Analysis ; Varicocele* ; Veins

Varicocele is a dilatation of plexus venosus in the spermatic cord. It rarely occurs before the age of puberty, but 15% of male teenager experienced varicocele (the rate is relatively high). This rate is higher when surveying data of male infertility (35% of primary infertility patients, and 75-81% of secondary infertility patients had experienced varicocele). Varicocele may affect both sides, but 90% of cases occurred in 1 side and among them 90% were in the left side. Microsurgery is a treatment with high rate of success
Varicocele ; Spermatic Cord ; Microsurgery ; diagnosis ; therapeutics ; knowledge

Varicocele is now a well established common cause of the male infertility and is a curable disease. Scrotal ultrasonography is a simple and reliable method for the diagnosis of varicocele because of noninvasiveness to the patient. Thus the urologists and radiologists try to use various diagnostic tools including physical examination to confirm significant varicoceles objectively. We used scrotal ultrasonography as a objective diagnostic method to evaluate 19 varicocele patients. Of 19 patients 17 had e palpable left varicocele clinically and a patient had bilateral varicoceles. All the clinical varicoceles were confirmed readily by sonography. By the sonography one case was demonstrated a left varicocele as a subclinical patient with infertility.
Diagnosis ; Humans ; Infertility ; Infertility, Male ; Male ; Physical Examination ; Ultrasonography* ; Varicocele*

Some physiological and ethical problems make it difficult to obtain semen samples from adolescents with varicocele (VC) and to directly evaluate their fertility. Therefore we can only rely on indirect methods to assess the influence of VC on the future fertility of the adolescent patients. Most of the VC adolescents may have normal semen parameters in the adulthood. Thus whether and when to intervene in adolescent VC remain a controversy in andrology. Physical examination is the most common method for screening adolescent VC and ultrasonography is very effective for its diagnosis and evaluation. Other important diagnostic indicators include the widely accepted testicular atrophy index, recently proposed peak retrograde venous flow, total testis volume, and scrotal temperature. Based on the latest literature, this review offers some proposals for the evaluation and intervention of adolescent VC.
Adolescent ; Humans ; Infertility, Male ; diagnosis ; Male ; Semen ; Semen Analysis ; Testis ; pathology ; Varicocele ; diagnosis

Varicocele is the most frequent cause of male subfertility. Because it is the most common surgically correctable cause of male infertility, its diagnosis is important. For diagnosis of varicoceles, venography, thermography, and doppler stethoscope were available, but they involved invasiveness, inaccuracy, lack of objectivity and cosiliness. Two noninvasive methods for detecting varicoceles. scrotogram using Technetium and digital infrared thermography imaging(DITI), were evaluated in 52 patients complaining of infertility. The results of scrotogram and thermography were not consistent in these patients. When the varicoceles were confirmed with internal spermatic venography or high ligation of internal spermatic vein, the physical examination was the most accurate method. compared with scrotogram and thermography. Scrotogram (0.73) was more sensitive than thermography(0.64). The each combination of the two of physical examination scrotogram and thermography increased the accuracy in terms of sensitivity and positive predictive value. This study suggest that the combination of scrotogram and thermography with physical examination would increase the diagnostic accuracy in the varicoceles.
Diagnosis* ; Humans ; Infertility ; Infertility, Male ; Ligation ; Male ; Phlebography ; Physical Examination ; Stethoscopes ; Technetium ; Thermography* ; Varicocele* ; Veins

PURPOSE: Retrograde flow is the main criterion for the diagnosis of varicocele, and the Duplex Doppler ultrasonographic values for retrograde flows are poorly defined. The purpose of this study is to assess a relationship between the palpated varicocele and pampiniform plexus diameter and the retrograde flow that was investigated with performing Duplex Doppler ultrasonography (DDU). MATERIALS AND METHODS: Physical examinations and DDU were performed to assess varicoceles in forty patients with left-sided varicocele and also in eight men who were without varicocele on their physical examination. During both normal respiration and the Valsalva's maneuver, the maximum diameters of the pampiniform plexus and the presence of the retrograde flow were measured by DDU. RESULTS: The highest mean venous diameter in the patients with clinical grade III varicocele was 2.7mm (2.4-3.6), and this was significantly higher than that in the patients with grade I (1.9mm) or with grade II varicocele (2.1mm) (p<0.05). While the difference of diameters between grade I and grade II was not significant, venous reflux was found in all degrees of the varicocele veins. Venous reflux during the Valsalva maneuver (type II flow pattern) was detected on the right side in one (8%) of 13 patients with grade II varicocele, and in three (21%) of 14 patients with grade III varicocele. The type III flow patterns, indicating augmenting of the reflux with an intra-abdominal pressure increase, were 46.1%, 69.2% and 100% for grade I, II and III, respectively. No venous reflux was found in the control group. CONCLUSIONS: The presence of retrograde flow may provide a more reliable indicator than does the spermatic vein diameter for the diagnosis of varicocele. When the palpability of the pampiniform plexus is questionable, Duplex Doppler ultrasound is indicated.
Diagnosis ; Humans ; Male ; Physical Examination ; Respiration ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Valsalva Maneuver ; Varicocele* ; Veins

The varicocele, a correctable cause of male infertility, affects both testes in histologically and physiologically, and the testicular damage is related to the duration of the varicocele. But the correction of an adolescent with a varicocele is controversial. To evaluate the efficacy of early surgical correction of the varicocele, seminal analysis was compared preoperatively and postoperatively for 6 months in 52 adolescents. In all the patients, improvement of postoperative men quality was observed with statistical significance, but morphology was not changed. operative abnormal semen quality was noted in 12 patients and was improved in 5 patients postoperatively. According to this results, early diagnosis and early surgical correction in adolescent with varicocele maybe prevent further testicular damage and increase fertility ultimately.
Adolescent* ; Early Diagnosis ; Fertility ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Testis ; Varicocele

PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Diagnosis ; Humans ; Mass Screening ; Pathology ; Physical Examination ; Ultrasonography ; Ultrasonography, Doppler* ; Valsalva Maneuver ; Varicocele* ; Veins

PURPOSE: To evaluate the hemodynamic status of varicocele, 99m Tc-RBC venography was performed in 29 varicocele patients and 10 normal controls from January to July 1996. MATERIALS AND METHODS: The mean age of varicocele patients was 23 years old and of normal controls was 27 years old. Among 29 varicocele patients, 26 had varicocele in left side and 3 had in both side. In unilateral varicocele group. 2 cases had grade I, 8 cases had grade II and 16 cases had grade III varicocele. In bilateral varicocele group, all had grade III in le% side and grade II varicocele in right side. RESULTS: The mean+/-SD of left to right radionuclide uptake ratio in pampiniform plexus during resting and Valsalva maneuver state was 1.01 +/-0.04:1 and 1.05+/-0.05:1 in normal control, 1.05+/-0.02:1 and 1.10:1 in varicocle grade I, 1.21+/-0.19:1 and 1.21 +/-0.12:1 in varicocele glade II, 1.60+/-0.63:1 and 1.27+/-0.18:1 in varicocele grade III, 1 18+/-0.06:1 and 1.26 in bilateral varicocele. As varicocele grade be higher, the mean left to right radionuclide uptake ratio be larger during resting and Valsalva maneuver state. CONCLUSIONS: 99mTc-RBC venography can quantify the hemodynamic state of varicocele so we suggest that it is useful as a method of diagnosis and follow up in varicocele patient.
Adult ; Diagnosis ; Follow-Up Studies ; Hemodynamics* ; Humans ; Phlebography* ; Valsalva Maneuver ; Varicocele* ; Young Adult