A preliminary study of shear-wave elastography for the evaluation of varicocele in adolescents and young adults

Abstract

To compare the change of testicular stiffness during the Valsalva maneuver using shear-wave elastography (SWE) in adolescents and young adults with varicocele according to clinical severity and evaluate the role of SWE in the diagnosis of varicoceles.Methods: Patients undergoing testicular ultrasonography for diagnosis of varicocele or for follow-up after varicocelectomy from June 2016 to February 2017 were included in this study. 54 testicles of 27 consecutive patients (mean age, 15.9 years) were classified according to clinical grade (grade 0-3). Testicular mean stiffness (E mean) using SWE was measured at rest and during the Valsalva maneuver. The correlation between multiple ultrasonographic parameters (volume asymmetry, E mean at rest, and absolute and percentage changes of E mean during the Valsalva maneuver) and the clinical grade was assessed using a Spearman correlation test. Results:The E mean measured at rest was similar among the four clinical grades. During the Valsalva maneuver, increased testicular stiffness was more frequently observed in patients with grades 2 or 3 varicoceles, but rarely observed in those with grade 0 or 1 varicoceles. The changes in E mean were positively correlated with the clinical grade (all p-values < 0.001),whereas the E mean at rest and volume asymmetry were not (all p-values > 0.05). Conclusion:A transient and reversible increase of testicular stiffness during the Valsalva maneuver was observed in adolescents with high-grade varicocele, and the degree of stiffness change correlated with the clinical grade. SWE changes during the Valsalva maneuver could be used as a surrogate indicator of venous congestion.

Nomograms for Predicting Postoperative Sperm Improvements in Varicocele Patients

“…According to current literature, it is clear that age and BMI [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , varicocele grade [28] , [29] , [30] , [31] and testicular elasticity modulus [32] , [33] , [34] , [35] have a definite impact on male fertility and sperm quality. Interestingly, the multivariate logistic regression analysis showed that BMI had no predictive value for the improvement of sperm parameters after surgery.…”

Elastography in the Urological Practice: Urinary and Male Genital Tract, Prostate Excluded—Review

“…Ryu YJ noted no difference in the Emean SWE values during resting states but increased testicular stiffness during the Valsalva maneuver for grade II and III varicoceles [ 50 ].…”

Shear Wave Elastography for Assessment of Testicular Stiffness in Patients with Varicocele

“…As in previously conducted studies, automatically generated average stiffness values were used. [ 17 23 ] The average of the all 3 poles measurements was calculated. The results were recorded in units of kPa.…”