Scrotal infrared digital thermography in assessment of varicocele - pilot study to assess diagnostic criteria

Abstract

The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P < 0.0001 and P < 0.006 respectively. In all patients, temperature difference between pampiniform plexuses was ≥ 0.6 °C. In 92% of patients, temperature at left pampiniform plexus was equal or higher to thigh temperature with the mean temperature difference of 1.1 ± 1.1 °C. Temperature at right pampiniform plexus was colder than the thigh in 92% of patients. This study suggests diagnostic criteria of five thermographic signs to easily diagnose varicocele. Scrotal thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method.

Time-domain analysis of scrotal thermoregulatory impairment in varicocele

“…The Experimental data used in the present paper reported that all the computed parameters at the level of pampiniform plexuses and that of the testicle in the left scrotum (pp l + ts l ) could provide better diagnosis of the varicocele patients with respect to healthy subjects than right sided ones This result emphasizes on the importance of studying the left scrotum hyperthermia in the assessment of varicocele (Tucker, 2000; Merla et al, 2001, 2002b,c, 2004; Nogueira et al, 2009; Kulis et al, 2012a,b). …”

Varikosel tanısında kullanılan görüntüleme yöntemleri

“…[23] Skrotumun infrared dijital termografik incelenmesi skrotal cilt yüzeyinden ısı ölçümü yoluyla erken varikosel tanısında duyarlı, invaziv olmayan bir tanısal yöntemdir. [24] Skrotumun infrared dijital termografisi skrotal alanda ısı ölçümü için oldukça duyarlı infrared kamera kullanımı ile yapılır. [25] Termografi vücudun alt kısmı çıplak olarak ve ayakta durur iken yapılır.…”

“…İki pampiniform pleksus arası ısı farkı ≥0,6°C ise bununda ikincil termografik bulgu olarak kabul edilmiştir. [24] Sintigrafi Sintigrafik incelemeler başka infertilite nedeni saptanamayan erkeklerde subklinik varikosel tanı ve derecelendirilmesinde ve rekürren varikosellerin tanısında doğru ve invaziv olmayan bir yöntemdir. Buna ek olarak skrotumun vasküler hemodinamisinin saptanmasında da faydalıdır.…”

“…[34,35] Ancak hem sintigrafi için hem de venografi için uygulama farklılıkları ve standart tanı kriterlerinin olmaması bu yöntemlerin kullanımını kısıtlamıştır. [24,36,37] Ayrıca sintigrafik incelemelerde intravenöz radyoizotop kullanımının gerekli olması, yayımlanmış çalışmalarda yöntem standardının olmaması, sintigrafide saptanan bozukluklar ile tedavi sonuçları arasında açık bir bağlantının olmaması sintigrafinin rutin kullanımını engellemiştir. [34,35] US'nin yaygın kullanımı ile bu yöntemler devre dışı bırakılmıştır.…”

Age, the environment and our reproductive future: bonking baby boomers and the future of sex

“…This effect is only evident when spermatozoa are incubated at temperatures significantly above 37 8C; however, the clinical significance of such heat-induced stress is uncertain (De Iuliis et al 2009a, 2009b. The presence of a varicocoele might constitute a possible exception, because this condition is associated with a sustained elevation of testicular temperature, particularly on the left hand side (Kulis et al 2012), and the activation of ROS generation by the spermatozoa (Mostafa et al 2001, Pasqualotto et al 2008. Of greater clinical and biological interest may be reports of oxidative stress and DNA damage being caused in the germ line by radiofrequency electromagnetic radiation (RFEMR; De Iuliis et al 2009aIuliis et al , 2009b.…”