Effects of varicocele on testicles: Value of strain elastography: A prospective controlled study

Abstract

The aim of this study was to evaluate the structural changes in testicles of the patients with varicocele by strain elastography (SE) and to identify the relationship between semen analysis and hormone levels considering SE results. The patients were separated into two groups as varicocele and control, according to their physical examination and the scrotal colour duplex ultrasonography results. All patients underwent examination by hormonal profile, semen analysis, colour duplex ultrasonography and sonoelastography. Testicular volume, resistive index (RI) of intratesticular arterial flow, strain rate and varicocele measurements were recorded. The left testicle strain ratios (SR) median value was 0.18 (0.15–0.26) in the varicocele group and 0.25 (0.19–0.28) in the control group (p < 0.001). The median RI value was 0.59 (0.52–0.64) in the varicocele group and 0.52 (0.5–0.59) in the control group (p < 0.001). No difference was found considering volume between the right and left testicles in either group. These results showed that elastography could be useful to detect the damage caused by varicocele on testicles in early period. However, studies with more patients would help to increase elastography's value and reliability.

The usefulness of elastography in the evaluation and management of adult men with varicocele: A systematic review

“…The discrepancy in the above findings is explicable considering that infertile men with severe damage to spermatogenesis and semen abnormalities may have similar histological changes in both testicles extending up to the degree of testicular failure. Similarly, two studies using strain elastography reported inverse elasticity readings in VC testicles in comparison to controls [ 18 , 19 ]. If infertility is absent, no difference might be found between VC-bearing and normal testicles as reported in one study [ 20 ].…”

“…Using real-time strain elastography, Salama et al [ 18 ] reported a significantly higher strain ratio and elasticity scores in infertile men with VC in comparison to normal controls, whereas in a second study, the left testicle strain ratio median value was found to be significantly lower in oligospermic men in comparison to a normal group [ 19 ]. In a study by Küçükdurmaz et al [ 8 ], dyspermic men including men with VC had different strain ratio readings in comparison to controls but the authors after sub-analysis concluded that the presence of VC did not have effect on elastography findings.…”

“…Using strain elastography, a study showed no correlation with FSH in infertile men with VC (with dyspermia or normospermia), although the trial showed significant correlations of strain values with total motile sperm count and sperm morphology in infertile men with dyspermia (including men with VC) [ 8 ]. In another study, no significant relationship between the left testicular strain ratio and the seminal parameters, hormonal values and the left testicular volume was found in oligospermic infertile men with VC [ 19 ]. Finally, Salama et al [ 18 ] reported that the strain ratio and elasticity scores showed a significant negative correlation with sperm morphology, whereas the elasticity score showed a significant negative correlation with testicular volume.…”

Thymoquinone improves testicular damage and sperm quality in experimentally varicocele‐induced adolescent rats

“…Some studies have reported that varicocele causes a decrease in testicular weight and volume (Guo et al., 2018; Lipshultz & Corriere, 1977), while in others it does not affect (Bitkin et al., 2019; Zhang et al., 2018). In the present study, although testicular weight decreased significantly in the V group compared with the other groups, there was no significant difference between the groups in terms of testicular volume.…”

The Relationship Between Ultrasound and Semen Parameters in Male Infertility: Size and Elasticity Matters!

“…The strain ratio of the testis, especially the left side, is elevated in case of varicocele, well before the atrophy of the testis. Consequently, SE could be useful to detect the damage caused by varicocele [7]. The testicular stiffness and semen parameters are known to be connected too.…”