Color Doppler ultrasound investigation of varicocele

Liguori, Giovanni; Trombetta, Carlo; Garaffa, Giulio; Bucci, Stefano; Gattuccio, Ignazio; Salamè, Leonardo; Belgrano, E.

doi:10.1007/s00345-004-0421-0

Cited by 96 publications

(79 citation statements)

References 17 publications

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“…In the present study, the upgrading of varicocele from grade 2 to 3 by Doppler compared to palpation in 3 patients confirms the sensitivity of Doppler reported by others (16).…”

Section: Discuss'/onsupporting

confidence: 92%

Pelvic and Peripheral Venous Insufficiency: Different Presentations and Common Pathophysiology

Soliman

atta

Youssef

2006

The Egypt. J. of Fert.y of Steri.

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Introduction: Varicose veins are related to other diseases including varicocele or utero-ovarian varices. On the base of close physiopathologic relationships between varicose veins and gonadal varicosity we decided to evaluate the features of pelvic venous insufficiency in patients affected hy varicose veins. Methods: Seventy patients with different grades of chronic venous insufficiency (CVI) were included in the study. The patients were evaluated pre-operatively by color Doppler for grading of gonadal varicosity and assessment of valvular incompetence in the peripheral veins. Post-operatively, the number of valves in the stripped veins was correlated to the degree of gonadal varicosity. Results: Thirty patients were proved to have both peripheral and pelvic venous insufficiency. Higher grades of gonadal varices were associated with lesser number of saphenous valves. There was a significant relation hetween the Doppler grading of venous reflux in gonadal & peripheral veins. Conclusions: The incidence of varicocele associated with CVI was higher than the incidence of isolated varicocele. The bilateral development of gonadal and peripheral varicosity in female patients refers to mechanical compression followed by axial reflux. The association of lesser number of valves in the saphenous veins with higher grades of varicocele raises the possibility of generalized valvular scarcity as a cause of venous insufficiency.

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“…In the present study, the upgrading of varicocele from grade 2 to 3 by Doppler compared to palpation in 3 patients confirms the sensitivity of Doppler reported by others (16).…”

Section: Discuss'/onsupporting

confidence: 92%

Pelvic and Peripheral Venous Insufficiency: Different Presentations and Common Pathophysiology

Soliman

atta

Youssef

2006

The Egypt. J. of Fert.y of Steri.

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“…Only 3rd grade varicocele according to color Doppler classification was taken into consideration differently from previous randomized studies that usually consider clinical classifications, which are known to have low sensitivity (3).…”

Section: Discussionmentioning

confidence: 99%

“…The condition is more common in men in infertile marriages, in which it affects 25-40% of men with abnormal semen analysis (2,3).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To study the effect of high grade varicocele treatment in infertile patients. Materials and Methods: Seventy-five patients were selected by the following criteria: infertility persisting for more than 1 year; abnormal semen parameters; no other infertility--related disease; no obvious causes of infertility in the subject's partner; basal eco-color Doppler ultrasound demonstrating continuous reflux in the spermatic vein. All patients considered for the study had at least a six months period from the diagnosis to the surgery due to waiting list, choice of the patient or time needed to complete diagnostic evaluation of the couple. The surgical procedure was performed through an inguinal approach. All enrolled patients were counseled to have unprotected intercourse during the ovulation period in order to maximize the probability of pregnancy within the 6-month preoperative period. The achievement of pregnancy and semen parameters were recorded during the preoperative and postoperative period. Results: Two of the seventy-five patients were excluded because of persistent varicocele after surgery. The preoperative pregnancy rate was 1.3% (1 couple). The postoperative pregnancy rate was 42.5%. The stratification of pregnancies by semester showed a significantly higher rate in the first postoperative period (p = 0.0012). Mean time to conception was 13.5 months. Mean preoperative sperm count was 17.6x10 6 /mL compared to 19.7x10 6 /mL in the postoperative period (p < 0.0001). Mean percentage of progressive sperm motility was 13.7%, compared to 17.6% in the postoperative period (p < 0.0001). Mean percentage of normal sperm morphology was 7.6%, compared to 15.2% postoperatively (p < 0.0001). Conclusion: Surgical treatment of high grade varicocele proved to effectively treat associated infertility by improving seminal parameters and pregnancy rate in our patient cohort.

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“…23 In adolescents, the clinical utility of vein diameter measurement has not yet been fully established. For this reason, diagnoses based on vessel diameter alone are likely to be characterized by a high number of false posi tives and negatives 31 By comparison to adult anatomy, even relatively small varicoceles associated with veins with small diameters are easily palpable in the smaller scrotums of adolescents. In one study, 24 the majority of adolescent patients with a palpable and visible varico cele had an MVD of less than 2.6 mm.…”

Section: Vein Diametermentioning

confidence: 99%

“…Reflux types can be grouped according to the Hirsch 34 classifica tion, which distinguishes between spontaneous (inter mittent or continuous) and inducible (by the Valsalva maneuver) venous refluxes (Table 1). In a grading system originally proposed by Sarteschi 35 and later confirmed by Liguori,31 varicocele can be further classified into five grades according to the features, location, duration, and inducibility of the reflux (Table 1; Figures 5-8).…”

Section: Hemodynamic Grading Systemsmentioning

confidence: 99%

The hemodynamic approach to evaluating adolescent varicocele

et al. 2012

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| During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack of spontaneous improvement in adolescent patients with ≥20% asymmetry between testes. CDUS also enables the detection of varicocele resulting from reflux in the deferential vein adjunctive to a refluxing internal spermatic vein; a causality that accounts for approximately 15% of cases. In addition to a diagnostic role, hemodynamic parameters can be used to predict the risk of persistence or worsening asymmetry. Although further studies are necessary to validate single parameters, it seems that the more severe the reflux, the greater the likelihood that the patient will develop testicular asymmetry.

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Color Doppler ultrasound investigation of varicocele

Cited by 96 publications

References 17 publications

Pelvic and Peripheral Venous Insufficiency: Different Presentations and Common Pathophysiology

Pelvic and Peripheral Venous Insufficiency: Different Presentations and Common Pathophysiology

Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

The hemodynamic approach to evaluating adolescent varicocele

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