Color doppler sonographic evaluation of inter-relations between diameter, reflux and flow volume of testicular veins in varicocele

Kocakoç, Ercan; Serhatlioğlu, Selami; Kiris, Adem; Bozgeyik, Zülkif; Özdemir, Hüseyin; Bodakçı, Mehmet Nuri

doi:10.1016/s0720-048x(02)00182-1

Cited by 40 publications

(48 citation statements)

References 18 publications

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“…RFV was determined in each vein by means of at least 3 measurements. The patients with a VD of 1 2 mm on rest by B-mode gray scale or the ones with a reflux time longer than 1 s during Valsalva by CDUS were diagnosed as having varicocele [11] .…”

Section: Methodsmentioning

confidence: 99%

“…While many researchers stated that venography is the gold standard method for the diagnosis of varicocele, venography has not become widespread as it is invasive and expensive, requires special equipment and has a morbidity of 0.5-1% [1,5,10,11] . Color Doppler ultrasonography is a noninvasive and easily applicable method that quantitatively measures both blood flow parameters in spermatic vein and size of the pampiniform plexus [12,13] .…”

Section: Introductionmentioning

confidence: 99%

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Is There Any Additional Benefit of Venous Diameter and Retrograde Flow Volume as Measured by Ultrasonography to the Diagnosis of Suspected Low-Grade Varicoceles?

Bakırtaş

Çakan²,

Tuygun³

et al. 2009

Urol Int

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Aims: To investigate the relation between the findings of physical examination and ultrasonography and to evaluate whether venous diameter (VD) and retrograde flow volume (RFV) have any additional benefit to the diagnosis of suspected low-grade varicoceles. Methods: Five hundred and fifty-two patients who applied to our outpatient clinic due to infertility were assessed by physical examination (PE) and B-mode and color Doppler ultrasonography (CDUS). The correlation of VD and RFV with clinical grade and with each other was investigated in cases diagnosed as unilateral left varicocele. Results: Unilateral left varicocele was detected in 184 (33.3%) of 552 patients: mean VD of the subjects was 3.17 ± 1.02 mm and mean RFV in 160 patients with a reflux was 24.01 ± 13.76 ml/min. There was a correlation of clinical grade both with VD and RFV (r = 0.669, p < 0.001 and r = 0.603, p < 0.001, respectively). Considering VD and RFV, there was a significant difference between grade (G)1–G2 and G2–G3 (p < 0.001, p < 0.001, respectively) except between subclinic-G1 varicocele groups (p = 0.626, p = 0.529, respectively). The best cut-off point predicting the palpable varicocele on physical examination was 3.1 mm (sensitivity 58.2%) for VD and 14.5 ml/min (sensitivity 83.8%) for RFV. Conclusions: Measurement of RFV is more sensitive than that of VD in predicting palpable varicocele. However, neither of them seem to have any additional benefit to PE in clarifying the diagnosis of suspected low-grade varicoceles.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is There Any Additional Benefit of Venous Diameter and Retrograde Flow Volume as Measured by Ultrasonography to the Diagnosis of Suspected Low-Grade Varicoceles?

Bakırtaş

Çakan²,

Tuygun³

et al. 2009

Urol Int

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“…Some clinical researchers recommend measuring vein diameter at the lower pole, 23 but the most commonly used measurement is maximum vein diameter (MVD) of the pampiniform plexus, assessed during the Valsalva maneuver with the patient in the supine position. 24,25 Multiple measure ments of the same vessel (typically ≥3) are recommended to ensure consistency. 25 In adults, vein diameter has been shown to corre late with the presence of reflux in the vein, although proposed threshold values vary.…”

Section: Vein Diametermentioning

confidence: 99%

“…24,25 Multiple measure ments of the same vessel (typically ≥3) are recommended to ensure consistency. 25 In adults, vein diameter has been shown to corre late with the presence of reflux in the vein, although proposed threshold values vary. A threshold value of 3 mm has been suggested by one research group, on the basis that only 62.3% of patients with an MVD below this value had a venous reflux, compared to 94.4% of patients with an MVD above this value.…”

Section: Vein Diametermentioning

confidence: 99%

“…A threshold value of 3 mm has been suggested by one research group, on the basis that only 62.3% of patients with an MVD below this value had a venous reflux, compared to 94.4% of patients with an MVD above this value. 25 Other research ers have proposed different threshold values based upon observations that, in a study of 156 testicles, all veins with an MVD of greater than 3.5 mm demonstrated reflux, whereas only one case of reflux was established in veins with an MVD of less than 2.5 mm, and 65% of veins with a MVD of 2.5-3.5 mm exhibited reflux. 26 In another study of 270 adult men, varicocele diag nosis was dependent upon an MVD of at least 2.45 mm at rest (sensitivity = 84%; specificity = 81%) or 2.95 mm during the Valsalva maneuver (sensitivity = 84%; specificity = 84%).…”

Section: Vein Diametermentioning

confidence: 99%

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The hemodynamic approach to evaluating adolescent varicocele

et al. 2012

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| During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack of spontaneous improvement in adolescent patients with ≥20% asymmetry between testes. CDUS also enables the detection of varicocele resulting from reflux in the deferential vein adjunctive to a refluxing internal spermatic vein; a causality that accounts for approximately 15% of cases. In addition to a diagnostic role, hemodynamic parameters can be used to predict the risk of persistence or worsening asymmetry. Although further studies are necessary to validate single parameters, it seems that the more severe the reflux, the greater the likelihood that the patient will develop testicular asymmetry.

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Intratesticular arterial resistance and testicular volume in infertile men with subclinical varicocele

Akcar

Turğut

Adapınar

et al. 2004

J of Clinical Ultrasound

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Color doppler sonographic evaluation of inter-relations between diameter, reflux and flow volume of testicular veins in varicocele

Cited by 40 publications

References 18 publications

Is There Any Additional Benefit of Venous Diameter and Retrograde Flow Volume as Measured by Ultrasonography to the Diagnosis of Suspected Low-Grade Varicoceles?

Is There Any Additional Benefit of Venous Diameter and Retrograde Flow Volume as Measured by Ultrasonography to the Diagnosis of Suspected Low-Grade Varicoceles?

The hemodynamic approach to evaluating adolescent varicocele

Intratesticular arterial resistance and testicular volume in infertile men with subclinical varicocele

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