Shunt-type and stop-type varicocele in adolescents: prognostic value of these two different hemodynamic patterns

Mohseni, Mohammad Javad; Nazari, H; Amini, Erfan; Javan-Farazmand, Niloufar; Baghayee, Arash; Farzi, Hossein; Kajbafzadeh, Abdol‐Mohammad

doi:10.1016/j.fertnstert.2011.08.024

Cited by 13 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This can be explained by the fact that there is continuous refluxing of blood to the testes in shunt-type varicocele, whereas in stop-type varicocele, reflux occurs only during straining. This can be confirmed by the observation of Mohseni et al 22 who reported that shunting appears to be a precondition for significant varicocele and therefore might have some prognostic importance for the subfertility associated with varicocele.…”

Section: Discussionsupporting

confidence: 66%

“… 21 On the basis of color Doppler sonographic findings, varicocele was classified hemodynamicaly into 2 different types: Shunt type and stop/pressure type. 22 Shunt-type varicocele showed continuous reflux during Valsalva in both retrograde and orthograde directions ( Figure 2A ). The stop/pressure type varicocele showed short phase of initial retrograde flow during Valsalva maneuver ( Figure 2B ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Alshehri

Akbar²,

Altwairgi³

et al. 2015

SMJ

View full text Add to dashboard Cite

Objectives:To assess duplex ultrasound (DUS) parameters, and predicti the outcome of varicocele ligation in male infertility.Methods:This retrospective and follow up study was conducted at Dr. Sulaiman Al Habib Hospital, AlQassim, Saudi Arabia between January 2011 and December 2012. Eighty-two patients were selected, who presented with clinical/subclinical varicocele and male infertility. All these patients had DUS of the scrotum and underwent for low ligation varicocelectomy. These patients were followed for a period of 12-24 months after surgery for the occurrence of paternity. We reviewed pre-operative scrotal DUS of these 82 patients for the testicular size and volume, pampiniform veins caliber and duration of reflux in the dilated veins at rest, and after valsalva maneuver. These DUS parameters were correlated with the postoperative paternity rate.Results:Postoperative paternity was achieved in 18 patients (31.6%) with normal-sized testes, and in 3 patients (12%) with small size testes. The positive paternity rate was higher (38.5%) in patients with clinically detected varicocele, compared with only 16.7% of patients with subclinical varicocele (detected by ultrasound only). In addition, postoperative paternity was significantly higher in patients with bilateral varicocele (70.6%), with shunt-type varicocele (71.4%), and patients with a permanent grade of venous reflux (62.5%).Conclusion:Selection of patients for the successful paternity after varicocele repair depends mainly on DUS parameters, which includes normal size testicles with shunt type of bilateral varicocele and continuous reflux.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Methodsmentioning

confidence: 99%

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Alshehri

Akbar²,

Altwairgi³

et al. 2015

SMJ

View full text Add to dashboard Cite

show abstract

“…Pattern 1 is similar to stop-type reflux and indicates competence of the valves as far as retrograde flow fades out before the end of the Valsalva manoeuver [23]. Pattern 2, equivalent to shunt-type reflux, implicates some degree of weakness of the spermatic vein valves or secondary venous communications and it is associated with progression of testicular asymmetry if left untreated and has a higher risk of recurrence [27]. Also, pattern 2 combined with any degree of clinical varicocele puts adolescents at risk of testicular hypotrophy [28].…”

Section: Discussionmentioning

confidence: 99%

Bilateral disease and intratesticular haemodynamics as markers of dyspermia in patients with subclinical varicocele: A prospective study

Tsampoukas

Dellis

Papatsoris

2019

Arab Journal of Urology

View full text Add to dashboard Cite

Objective: To study scrotal ultrasonographic characteristics in patients with subclinical varicocele (SV) and investigate their relationship with semen parameters.Patients and methods: In all, 56 men with SV were recruited and divided into two groups, according to their semen characteristics. Group A, comprised 34 men with normal semen analysis; and Group B, comprised 22 men who carried at least one abnormality, regarding sperm concentration, motility and morphology. Between the two groups we compared: age; body mass index (BMI); semen pH and semen volume; total testicular volume (TTV); maximal vein diameter (MVD) and degree of reflux; mean values of peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the intratesticular arteries; whether bilateral SV; and serum testosterone and follicle-stimulating hormone (FSH) levels.Results: Asthenospermia was present in all patients in Group B; 10 patients had asthenospermia only, six patients were astheno-oligospermic and six patients had astheno-oligo-teratospermia. Age, BMI, semen pH and volume, TTV, MVD and degree of reflux did not differ significantly between the two groups (P > 0.05). However, EDV, PSV and RI were significantly different (P < 0.05). Bilateral SV was significantly more frequent in patients in Group B (P < 0.05). Finally, FSH was elevated in Group B (P < 0.05), whereas testosterone was normal in both groups, albeit significantly lower in men with abnormal semen analyses (P < 0.05).Conclusion: Classic ultrasonographic characteristics in men with SV, such as venous size or degree of reflux, were insufficient to distinguish patients with abnormal semen analysis. However, bilateral disease and intratesticular haemodynamics differed significantly in patients with SV and abnormal semen analysis.Abbreviations: BMI: body mass index; CDU: colour Doppler ultrasonography; EDV: end-diastolic velocity; MVD: maximal vein diameter; PSV: peak-systolic velocity; RI: resistive index; SV: subclinical varicocele; TTV: total testicular volume; US: ultrasonography

show abstract

“…In one the peak, velocity was measured upright with the patient breathing normally [ 95 ]. In another, the position of the patient is not reported [ 93 ]. Measurement were performed either in the largest vein [ 91 , 98 ], in the spermatic cord just cephalad to testis [ 99 ] or, in general terms, where reflux was identified [ 63 ].…”

Section: Systematic Review To Address Questionmentioning

confidence: 99%

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

et al. 2020

View full text Add to dashboard Cite

Although often asymptomatic and detected incidentally, varicocele is a relatively common problem in patients who seek medical attention for infertility problems. Ultrasound (US) is the imaging modality of choice for evaluation, but there is no consensus on the diagnostic criteria, classification, and examination technique. In view of this uncertainty, the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology (ESUR-SPIWG) undertook a systematic review of the available literature on this topic, to use as the basis for evidence-based guidelines and recommendations. This paper provides the results of the systematic review on which guidelines were constructed.

show abstract

Shunt-type and stop-type varicocele in adolescents: prognostic value of these two different hemodynamic patterns

Cited by 13 publications

References 28 publications

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Bilateral disease and intratesticular haemodynamics as markers of dyspermia in patients with subclinical varicocele: A prospective study

Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations

Contact Info

Product

Resources

About