The value of ultrasonography in the diagnosis of varicocele
A varicocele is described as pathologically enlarged, tortuous veins of the pampiniform plexus, leading to an increased testicular temperature and adrenal metabolite reflux into the testes. Varicocele can impair spermatogenesis and is considered to be the most common cause of male infertility. Pa...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2016-03-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-16-no-67/the-value-of-ultrasonography-in-the-diagnosis-of-varicocele?aid=477 |
| Summary: | A varicocele is described as pathologically enlarged, tortuous veins of the pampiniform
plexus, leading to an increased testicular temperature and adrenal metabolite reflux into
the testes. Varicocele can impair spermatogenesis and is considered to be the most common
cause of male infertility. Patients may palpate a thickening in the scrotum or complain
of dull scrotal or inguinal pain, which increases when standing or during erection.
In the case of a sudden onset of varicocele in elderly men, it is necessary to exclude renal
tumor and extend diagnostic ultrasound with the assessment of the abdominal cavity.
The diagnosis of varicocele is based on medical history and physical examination, which
involves palpation and observation of the scrotum at rest and during the Valsalva maneuver.
Ultrasound is the imaging method of choice. The width and the number of vessels
in the pampiniform plexus as well as the evaluation and measurement of regurgitation
during the Valsalva maneuver are typical parameters analyzed during ultrasound assessment.
However, diagnostic ultrasound is still a controversial method due to numerous
and often divergent classification systems for varicocele assessment as well as its poor
correlation with clinical manifestations. As a result of introduction of clear ultrasound
criteria as well as the development of elastography and nuclear magnetic resonance,
diagnostic imaging can play an important role in assessing the risk of damage to the
testicular parenchyma, qualifying patients for surgical treatment and predicting the effects
of therapy. |
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| ISSN: | 2084-8404 2451-070X |