Ultrasound diagnosis of varicocele in the adolescent: Our experience from Benin

Fiogbe, Michel Armand; Alao, Maroufou Jules; Biaou, Olivier; Gbenou, S Raphin A; Yèkpè, Patricia; Sossou, R; Metchihoungbe, Serge C

doi:10.4103/0189-6725.125403

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…Most studies have reported varicoceles to be more common on the left in both sub-fertile men and normal population [12][13][14][15]. Our findings were consistent with these.…”

Section: Discussionsupporting

confidence: 95%

“…Is there a relationship with race or geographical location? Fiogbe et al in Cotonou [15], also in West Africa, in a random screening of 2724 adolescents using scrotal US reported a bilateral prevalence of 87.6%. However, Gat et al [13] using a combination of multiple diagnostic tools, including scrotal US and venography also found a bilateral prevalence of 80.7% in infertile men and suggested that varicocele may actually be a bilateral disease.…”

Section: Discussionmentioning

confidence: 94%

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Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

Tijani

Oyende

Awosanya

et al. 2014

African Journal of Urology

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Objective: To determine and compare the spectrum of scrotal abnormalities in fertile and sub-fertile west African men using scrotal US. Subjects and methods: The study examined 249 subjects over a period of 13 months. The subjects comprised 149 patients with diagnosis of male infertility, as well as 100 healthy individuals for comparison. The relevant clinical history of each patient was extracted from their case notes. All the subjects had their testes examined using a high frequency (7.5 MHz) linear transducer of an ultrasound scanner. Images in B-mode ultrasound scan and color Doppler were acquired in the supine and upright position. The results were expressed as percentages and tests of significance were done using the chi-square and Fisher's t-test. A P-value < 0.05 was considered statistically significant. Results: The prevalence of abnormal scrotal findings in the sub-fertile and fertile men was 65.1% and 23% respectively (P < 0.01). Varicocele was the commonest and was found in 55% and 12% of the fertile and subfertile men respectively (P < 0.01). Hydrocele and epididymal abnormalities were the next common with higher prevalence in the sub-fertile men (P > 0.05), while testicular tumor was confirmed in one sub-fertile patient. With the exclusion of varicocele, there was no statistically significant difference in the prevalence of the other abnormalities between the sub-fertile and fertile groups.Scrotal abnormalities and infertility in west African men 181 Conclusion: Male sub-fertility was associated with a higher prevalence of scrotal abnormalities. Apart from the diagnoses of the possible causes of the sub-fertility, routine scrotal US was able to diagnose other abnormalities of clinical relevance in the sub-fertile male. Scrotal US is a valuable tool in the evaluation of the sub-fertile west African man and should be considered in the routine evaluation of the sub-fertile west African man.

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“…Most studies have reported varicoceles to be more common on the left in both sub-fertile men and normal population [12][13][14][15]. Our findings were consistent with these.…”

Section: Discussionsupporting

confidence: 95%

Section: Discussionmentioning

confidence: 94%

Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

Tijani

Oyende

Awosanya

et al. 2014

African Journal of Urology

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“…A venous reflux of the pampiniform plexus within the spermatic cord of longer than 2 s detected with CDU in orthostatism and with a Valsalva maneuver constituted a varicocoele (i.e., significant reflux) (Sheehan et al ., ). The reflux was assessed semiquantitatively in orthostatism according to the literature (Fiogbe et al ., ) which indicates three grades of reflux: (i) significant reflux present only during the Valsalva maneuver (discontinuous reflux); (ii) significant reflux present even in the absence of Valsalva maneuver but increased by the Valsalva maneuver (continuous reflux increased by Valsalva), and (iii) significant reflux present even in the absence of the Valsalva maneuver but not increased by the Valsalva maneuver (continuous reflux not modified by the Valsalva maneuver). The CDU scrotal examinations were carried out according to the American College of Radiology guidelines (American College of Radiology et al .…”

Section: Methodsmentioning

confidence: 99%

The clinical usefulness of a novel grading system for varicocoeles using duplex Doppler ultrasound examination based on postsurgical modifications of seminal parameters

2018

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Background: The existing classifications of varicocoeles have poor predictive value regarding the effects of surgery on sperm count. Objective: To develop a new grading system for varicocoeles, useful as an indication for surgery. Materials and methods: This is a three-center prospective study which examined 173 men having clinically detectable left varicocoeles and oligo AE astheno AE terato-spermia. The patients underwent medical history collection, objective examination, duplex Doppler ultrasound scrotal examination, hormonal profiles, two semen analyses before surgery, and two semen analyses after surgery. Sperm concentration, motility, and morphology (standard semen parameters) were evaluated 6 months after surgery in function of the following preoperative variables: patient age, follicle-stimulating hormone, clinical grade of varicocoele, right and left testicular volume, extension of venous reflux, and semen parameters. The venous reflux was graded in two centers using duplex Doppler ultrasound: reflux visible only with Valsalva and continuous reflux. Spearman's rank semiquantitative analysis was used. All patients had their varicocoeles corrected according to the Colpi technique. Results: The variables capable of determining an improvement in semen parameters after varicocoele correction were in order of decreasing importance: venous reflux extent assessed by scrotal duplex Doppler ultrasound examination, varicocoele clinical grade, basal semen parameters, and follicle-stimulating hormone. Male age did not influence postoperative semen quality. Only patients with continuous reflux had their standard semen parameters improved after surgery. Discussion: Venous reflux extent is the most critical variable capable of predicting semen improvement after varicocoelectomy. Conclusions: A correct duplex Doppler assessment of venous reflux is mandatory for predicting postoperative improvement of the sperm count.

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“…Using US, Fiogbe et al [36] assessed the presence of subclinical varicocele in 81 adolescents aged 10-19 years who had a varicocele on one side. In 50 patients (61.7%), subclinical varicocele was detected.…”

Section: Subclinical Varicocele In Adolescentsmentioning

confidence: 99%

A challenging ‘bag of worms’

Younis¹,

Hamed²

2015

Human Andrology

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About 4.6-16.2% of male adolescents may be affected by varicocele. The most important damaging effect of varicocele in adolescents is testicular growth arrest (hypotrophy). Ultrasound is more accurate compared with orchidometry in detecting hypotrophy. Histopathologically, the testis of adolescent boys affected by varicocele shows Leydig cell hyperplasia, decreased number of spermatogonia per tubule, spermatogenesis arrest, and sloughing of the germinal epithelium. Varicocele in adolescents negatively affects sperm density and motility, and this seems to be related to testicular volume. To treat or not to treat adolescent varicocele is a controversial question. This is due to conflicting reports about the effectiveness of varicocelectomy. On one hand, some studies demonstrated a significant catch-up growth of the testis but found that prophylactic varicocele repair might expose many individuals to the unnecessary risks of surgery. Furthermore, this catch up of testicular volume could be due to edema secondary to severing of lymphatics during the procedure. On the other hand, other studies found that varicocele correction in adolescents not only improved testicular hypotrophy but also improved semen quality. Complications of varicocelectomy, such as recurrence or hydrocele incidence, are less common in open varicocelectomy than in laparoscopic or percutaneous embolization when treating varicocele in adolescents.

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Ultrasound diagnosis of varicocele in the adolescent: Our experience from Benin

Abstract: TH due to varicocele is better studied by ultrasound.

Cited by 10 publications

References 20 publications

Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

The clinical usefulness of a novel grading system for varicocoeles using duplex Doppler ultrasound examination based on postsurgical modifications of seminal parameters

A challenging ‘bag of worms’

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