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At least 19 recordsLinked to original sources
PubMed1983

Testicular arterial perfusion in varicocele: the role of rapid sequence scintigraphy with technetium in varicocele evaluation.

Rapid sequence scintigraphy was used to study testicular arterial perfusion and venous stasis in 53 patients with varicocele-associated infertility, 17 with idiopathic testicular failure and 9 treated for varicocele. Arterial blood supply to the diseased testicle was decreased in 63 per cent of the patients with subclinical or low grade varicocele compared to 18 per cent with idiopathic testicular failure. In the majority of cases the disturbance of perfusion disappeared immediately after interruption of retrograde blood flow in the internal spermatic vein by transcatheter embolization, whereas persistently impaired perfusion was found in a few cases with no improvement of semen quality after treatment. Venous stasis was found in only 18 per cent of the patients with low grade varicocele compared to 88 per cent with large varicoceles. It is suggested that impaired arterial blood supply rather than venous stasis is the pathogenic factor in epididymo-testicular dysfunction associated with low grade varicocele.

Humans↗
PubMed1986

[Noninvasive imaging procedures in the diagnosis and therapy control of varicoceles. I: Sonography and thermography in the diagnosis of varicoceles].

69 patients with clinically suspected varicoceles were examined thermographically and sonographically prior to testicular phlebography. The combination of sonography and thermography permitted precise differentiation into normal findings (7%), left-sided varicoceles (86%) and bilateral varicoceles (7%). Thermography was advantageous with an accuracy of 97.3%. Sonography had an accuracy of 90.5%. No clear correlation was found between varicocele size and degree of hyperthermia. The combination of sonography and thermography affords a high degree of accuracy in the diagnosis of varicoceles, including subclinical and infantile varicoceles.

Adolescent↗
PubMed1990

Improvement of semen characteristics after surgical repair of bilateral testicular varicocele as compared to unilateral varicocele patients.

The operative treatment for surgical repair of bilateral testicular varicoceles was evaluated in terms of the improvement achieved in the sperm density and percentage progressive motile sperm. These parameters were compared for 27 cases of bilateral varicocele diagnosed by palpation and subjected to bilateral high ligation of the internal spermatic vein and for 40 cases of left unilateral testicular varicocele. There were no significant differences in preoperative values (such as sperm density; progressive motile sperm; serum levels of luteinizing hormone, follicle-stimulating hormone, and testosterone; and Johnson's score count) between the bilateral and unilateral testicular varicocele groups. The improvement in postoperative sperm density in the cases with bilateral testicular varicocele was apparently less satisfactory than in the cases with testicular varicocele only on the left side.

Adult↗
PubMedDate not supplied

Surgical repair of secondary right varicocele in rats with primary left varicocele: effects on fertility, testicular temperature, spermatogenesis, and sperm maturation.

To evaluate whether or not dilation of the right testicular vein is a constant finding in animals with left varicocele and to illustrate its contribution to the detrimental effect of a left varicocele on the right testis, an experimental varicocele model was produced in 40 rats. Ten other rats had a sham operation (group A). Seven weeks after the operation, all 50 rats underwent laparotomy and dilation of both testicular veins was seen in 23 rats, which were randomly assigned to group B (n = 11) and group C (n = 12). One week later, groups A and C underwent sham ligation of the right testicular vein, whereas group B rats underwent resection of this vein. At 84 days after the initial operation, group C rats showed a significant reduction in right epididymal sperm content, motility, and fertilizing capacity, right testicular weight, and right testicular vs. intraabdominal temperature difference when compared with groups A and B. Since surgical repair of the secondary right varicocele improved all the parameters indicating the harmful consequences of the primary left varicocele on the right testis, it appears that dilation of the right testicular vein contributes to the detrimental effect of a left varicocele on the right testis.

Animals↗
PubMed1990

[Male varicocele. Analysis of the incidence of varicocele in a population of 18,800 young men].

The authors evaluate the incidence of varicocele after having examined 18,800 healthy white men members of the Italian Army Corps born in 1966 and visited in 1985. They found a varicocele in 775 patients (4.12%), in 5 was present bilaterally, and in 770 in the left side. In 45 patients the surgical treatment was already done at the time of the examination and there were 3 recurrences. The patients with varicocele were divided according to the classification of Dubin-Amelar and were: grade I n. 175 (0.93%); grade II n. 515 (2.74%); grade III n. 35 (50.18%). In 566 (73.03%) the diagnosis was done at the moment of the examination, 152 (19.62%) discovered the varicocele at the self examination; in 57 (7.37%) the diagnosis was already done by the family doctor. Infertility is sometime associated to the varicocele and with the unrelieved local discomfort are the main indications for surgery. It should be also emphasized the need of education on the infertility problems during the high school that is a time of the life in which there is the highest incidence of varicocele.

Adult↗
PubMed1987

[Diagnosis of varicocele with bidirectional Doppler sonography. A contribution to the pathogenesis of varicocele].

A total of 375 patients with varicocele were examined by bidirectional Doppler sonography. Venous reflux was classified as one of two Doppler grades: spontaneous reflux and Valsalva-induced reflux. The Doppler grades were compared with clinical aspects (e.g. size) of the varicocele. Using bidirectional recording, it is possible to describe two hemodynamically different types of varicoceles (the pressure type and the shunt type). On the basis of the Doppler results the pathogenesis of varicocele can be determined. Spontaneous reflux causes the shunt type and the medium-sized and large varicocele, while Valsalva-induced reflux causes the pressure type or the stop type and the small and subclinical varicocele.

Blood Flow Velocity↗
PubMed1986

Hemodynamics of the varicocele. Part II. Correlation among the results of renocaval pressure measurements, varicocele scintigraphy and phlebography.

Left renal vein compression occurring mainly with the patient in the upright position, and being less severe or absent in the supine position, was considered to be the main cause of varicoceles. We show that left renal vein compression is, indeed, more severe with the patient in the upright than in the supine position and that it produces a left renocaval pressure gradient that is responsible for the retrograde blood flow in the left testicular vein. This pressure gradient, which was determined in the supine and semierect positions in 34 patients, increased from a mean of 3.8 mm. Hg in the supine position to a mean of 7.8 mm. Hg in the semierect position. On the basis of the assumption that the renocaval pressure gradient measured with the patient in the semierect position determines the presence and velocity of a retrograde flow in the left testicular vein, as shown by the dynamic portion of the varicocele scintigram (see part I), these variables were analyzed and the correlation coefficient proved to be good. Therefore, we conclude that the varicocele occurs when the left testicular vein lacks valves or there is a renogonadal bypass, and the severity of the left renal vein compression in the (semi) upright position determines the velocity of the retrograde flow in the left testicular vein and the size of the varicocele.

Blood Pressure↗
PubMed1992

Surgical repair versus medical treatment of varicocele in the rat: pharmacological manipulation of the varicocelized testicle.

Human chorionic gonadotropin, kallikrein, indomethacin, and hydralazine were administered to different groups of varicocelized rats, while surgical repair of the varicocele was performed in another group of rats. The effects of conservative and surgical treatment on epididymal sperm content and motility, the weights of the testes, epididymis, and male accessory genital glands, and fertility were compared between each group and a sham-treated group of rats. Surgical repair significantly improved all the evaluated parameters and all the conservative regimens, except hydralazine, resulted in a significant improvement in most parameters. Our results indicate that stimulation of the Leydig or/and Sertoli cells of a varicocelized testicle can counteract some of the detrimental consequences of the varicocele itself.

Animals↗
PubMed1989

Hemodynamics of varicoceles: venous shunting in grade II and III varicoceles.

In 42 consecutive patients with moderate (grade II) or large (grade III) left-sided idiopathic varicoceles, which were referred for percutaneous sclerotherapy, not only the reflux in the testicular vein but the venous drainage as well was studied by venography. As suggested by bidirectional Doppler sonography the reflux in the testicular vein is always associated with an upward (in physiologic direction) flow in these varicoceles. The draining veins are shown to be the deferential, cremasteric, external pudendal, or any combination of these. Thus, the grade II and III varicoceles are termed shunt-type varicoceles.

Collateral Circulation↗
PubMedDate not supplied

Induction of varicocele in the dog: I. Partial ligation of the left renal vein does not induce a varicocele in the dog.

Induction of varicocele was attempted by partial ligation of the left renal vein in 10 male dogs. The effects on sperm count, sperm motility, and sperm morphology, as well as on hemodynamics, were assessed. Furthermore, testicular, vascular, and kidney morphology was studied. Changes in the diameter and consistency of the left spermatic cord were found to be temporary. Total sperm count, sperm motility, and the total number of oval forms were not significantly altered. Hemodynamic studies revealed a renocaval pressure gradient, but retrograde flow in the distal part of the left testicular vein could not be observed by arteriography. A collateral network was found to compensate for the restricted left renal vein. Histologic examination revealed no damage to the seminiferous epithelium. Changes were not found in the kidney and left pampiniform plexus. Although some temporary changes induced by the partial ligation of the left renal vein are suggestive of varicocele, this hemodynamic study shows that the presented dog model does not mimic varicocele as encountered in man.

Animals↗
PubMed1986

[Non-invasive imaging procedures in the diagnosis and control of therapy of varicoceles. 2. Importance of thermography and sonography for therapy control following sclerotherapy of varicoceles].

In 41 patients with varicoceles, a combined thermographic and sonographic examination of the scrotum was carried out pretherapeutically as well as 14 days and 3 months after percutaneous sclerotherapy. In the differentiation of a successful sclerosing or a varicocele persistence, thermography shows a higher sensitivity than sonography with 34 posttherapeutic normal findings and 7 persisting hyperthermias. The sonographic sign of a successful varicosclerosation is the absence of venous dilation of the pampiniform plexus in an upright position with Valsalva's manoeuvre in 36 patients. After proximal sclerosing of the testicular vein sonography reveals a reduction in vascular size; thrombosed veins of the pampiniform plexus are demonstrated only after distal sclerosing. There are no sonographically detectable disorders of the testes after varicosclerosation. Thermographic and sonographic control after percutaneous sclerotherapy or surgical ligation of varicoceles is indicated in children and in doubtful clinical or spermatological cases.

Adolescent↗
PubMed1988

[Clinical studies of varicocele. 1: Clinical statistical analysis of varicocele].

A clinical statistical analysis was conducted of the patients with varicocele who visited the Department of Urology, Osaka City University, and its related hospitals. Regarding the age distribution, patients younger than 50 years old were predominant; this age group included 20 of 24 cases, or 83%. An overwhelming majority of the cases, 75%, had the main complaint of infertility; they had not been able to have children even after 2 to 3 years of marriage. The next most common complaint was swelling and/or an uncomfortable feeling of the contents of the scrotum. In all of the cases, the lesion was seen in the left side of the scrotum. When the patients were classified on the basis of the sperm count, oligospermia was predominant; it was seen in 15 cases (62.5%). A study on the relationship between the sperm count and the grade of varicocele revealed a tendency for the sperm count to show an inverse relationship with the grade. Testicular atrophy showed a direct correlation with the grade. Of the patients with varicocele, 5 patients had one or more children, while 8 patients (61.5%) complained of their inability to have a child. No particular relationship could be identified between the age at the time of visiting our Department as outpatients and the degree of testicular atrophy.

Adolescent↗
PubMed1984

Haemodynamic aspects of left-sided varicocele and its association with so-called right-sided varicocele.

A method has been developed which uses a radionucleotide to demonstrate retrograde bloodflow in the testicular vein and the size of the pampiniform plexus in patients with a varicocele. This method and phlebography were both performed in 71 patients. The radionucleotide method was reliable in showing retrograde flow in the testicular vein and enabled quantification of the size of the pampiniform plexus. On the right side, however, retrograde bloodflow or an enlarged pampiniform plexus were not found in any of the 71 patients. Misinterpretation of phlebographic and radionucleotide studies are probably responsible for recent reports on the frequent occurrence of right sided varicocele.

Humans↗
PubMed1988

[Clinical studies of varicocele. 2: Radiographic examination and measurement of spermatic vein pressure in varicocele patients].

There are two types of internal spermatic veins (ISV) by radiographic examinations. In type 1, ISV is dilated with some collateral venous branches. On the other hand, ISV of type 2 is narrowed with increased collateral venous branches or abnormalities such as the circumaortic renal are seen. In these groups, pressure of renal vein and ISV were measured. As a result, renal vein pressure was about the same in type 1 as in the controls at 9.5 +/- 2.3 cmH2O but was higher in type 2 at 17.0 +/- 2.8 cmH2O. As for ISV, it was also about the same in type 2 as in the controls at 13.9 +/- 6.8 cmH2O but was markedly higher in type 2 at 33.3 +/- 3.9 cmH2O. When selective renal venography was performed, a contrast medium back-flow was seen in 9 out of 11 type 1 varicocele patients, but it was not seen in any of the cases with the nutcracker phenomenon. These results suggested that type 1 may be caused by the structural and functional disorders in the valve between the renal vein and ISV. In contrast, pathogenesis of type 2 varicocele may be due to an abnormality of the ISV in the embryo.

Humans↗
PubMed1979

[Improvement of male fertility through ligation of varicocele? A study of 100 subfertile varicocele patients three months after ligation (author's transl)].

With 100 subfertile varicocele patients, three months after ligation (high ligation of the left internal spermatic vein in accordance with Bernardi) had control spermiograms made. An improvement of sperm count (upgrade in a higher class according to MacLeod's partition) was found in 28% of the cases, whereas an improvement of progressive motility was found only in 13%. The percentage of patients reaching the normal value in sperm count of over 40 mill./ml increased from 23% to 39%. The increase in these patients came primarily from the class of 20--40 mill./ml. In progressive motility, there was an increase of patients reaching the standard value of over 40%, from 6 to 11. However, if sperm count and progressive motility together were evaluated in the individual patients after ligation, only 6 patients presented a normospermia, i.e. a sperm count of more than 40 mill./ml with normal progressive motility. Thus 94 of the 100 patients must be considered as subfertile three months after ligation. A significant fertility improvement through ligation of varicocele has not yet taken place.

Adult↗
PubMed1990

[Diagnostic screening of varicocele: role of echography and Doppler examination in our experience with 216 cases of primary varicocele].

We compared two non-invasive methods to evaluate primary varicoceles: ultrasonography and Doppler examination. We submitted to ultrasonography and Doppler 216 patients, 147 of them were treated by sclerotherapy and 69 by surgery. All ultrasonographic studies were performed by means of a real-time equipment (7.5 Mhz transducer), while Doppler examination was performed with continuous wave equipment. Ultrasonographic findings are reliable for testicular morphology. Doppler examination is useful to evaluate reversed flow. In 4.1% of cases ultrasonography did not agree with the Doppler examination.

Humans↗
PubMed1988

[Clinical studies of varicocele. 3: A rare venous return via Santorini's plexus in a varicocele patient. Report of a case].

A 12-year-old man was referred to our clinic because of sanguineous discharge. At the out-patient department, bilateral varicocele was found. Urinalysis showed microscopic hematuria, but no other laboratory data were abnormal. Excretion urography was normal. The retrograde phlebograph showed a rare venous return via Santorini's plexus and lumbar veins. After varicocelectomy, urinalysis improved.

Child↗