Is There a Link Between Saphenofemoral Insufficiency and Varicocele: Imaging Study of Sub-Fertile Men

Abstract

Background:Varicocele is an important cause of infertility in men. Some studies have suggested that because of the similar pathologic processes involved in chronic venous diseases and varicocele, saphenofemoral insufficiency is an example of chronic venous disease, which causes varicose veins in the lower extremity. It is thought that there may be a relation between saphenofemoral abnormality and the emergence of varicocele, but this relation is not backed by sufficient evidence. Methods: In this prospective diagnostic study, a total of 50 patients suffering from varicocele and 50 control patients were included. Ultrasonography was performed to determine the emergence of saphenofemoral insufficiency (SFI). Results:Mean age of patients in the varicocele group and the control group was 32.4 ± 8.44, and 34.9 ± 6.39, respectively. Out of 50 patients being included in the study with varicocele, 8 had left sided SFI and 9 had right sided SFI, while in the control group, 4 patients were diagnosed with SFI, 2 on each side. The difference between the two groups was statistically significant. There was no relation between the time from diagnosis of varicocele, side of varicocele and the existence of saphenofemoral insufficiency. Conclusions: Saphenofemoral insufficiency was shown to be significantly related to varicocele, and can be a sign of probability of emergence or re-emergence of varicocele, and further can be used in clinical examination to guide clinicians in diagnosing varicocele.

The association between varicocele and other vascular diseases: A systematic review and meta-analysis

“…Five of the seven included case-control studies reported the risk of saphenofemoral insufficiency in the varicocele and control groups. 6,[8][9][10]13 In four studies, saphenofemoral insufficiency was defined as femoral saphenous reflux time greater than 0.5 s. In one remaining study, femoral saphenous reflux was defined as retrograde flow of more than 1 s. Ultimately, 872 cases were included, with 482 cases in the varicocele group and 390 cases in the control group. The pooled analysis indicated that the risk of saphenofemoral insufficiency in the varicocele group was higher than that in the control group (OR: 2.80; 95% CI: 2.03, 3.84; p < 0.00001; Figure 4), and low heterogeneity in the pooled effect estimates was found (p = 0.32; I 2 = 14%; Figure 4).…”