Intratesticular varicocele

Mehta, Amit; Dogra, Vikram S.

doi:10.1002/(sici)1097-0096(199801)26:1<49::aid-jcu11>3.0.co;2-h

Cited by 51 publications

(31 citation statements)

References 8 publications

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“…Intratesticular varicocele is a rare and relatively new entity, reported in fewer than 2% of symptomatic men undergoing testicular sonography as opposed to extratesticular varicoceles, which are present in 15% to 20% of men (14,15). Patients with intratesticular varicocele may have testicular pain secondary to venous congestion, resulting in stretch- ing of the tunica albuginea.…”

Section: Vascular Lesions Intratesticular Varicocelementioning

confidence: 99%

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Non neoplastic intratesticular masses

Bhatt¹,

Jafri²,

Wasserman³

et al. 2009

Diagn Interv Radiol

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High-frequency ultrasonography is the first modality of choice for the evaluation of scrotal pathology. The use of high-frequency ultrasound is increasing, allowing detection and better characterization of many benign intrascrotal lesions that can be treated with non-surgical management or testicular-sparing surgery.This pictorial essay presents gray-scale and color-flow Doppler features of non-neoplastic intratesticular masses. For ease of understanding, the review is organized into three major categories: cystic, vascular, and solid non-neoplastic masses. Table summarizes the key sonographic features, each with recommended management. Sonographic anatomy of the testisThe normal adult testes in each hemi scrotum are symmetric in size and measure approximately 5x3x2 cm. On ultrasound, a normal testis is identified by the presence of homogeneous, medium-level echoes and is contained by a fibrous sheath called the tunica albuginea. The tunica albuginea is identified on ultrasound as a thin echogenic line around the testis and is externally covered by the tunica vaginalis. The tunica vaginalis consists of visceral and parietal layers that are normally separated by a few milliliters (2-3 mL) of fluid. The tunica attaches to the scrotal wall at the posterolateral aspect of the testis. From the posterior aspect of the testis, the tunica albuginea invaginates within the testis to form an incomplete septum, called the mediastinum testis. Sonographically, the mediastinum testis appears as an echogenic band of variable thickness that extends across the testis in the longitudinal axis (Fig. 1). Multiple fibrous septa extend from the mediastinum into the testis, dividing it into 250 to 400 lobules. Spermatogenesis occurs within the seminiferous tubules contained within these lobules. The seminiferous tubules open into dilated spaces called the rete testis within the mediastinum via the tubuli recti. The normal rete testis can be seen on high-frequency US in 18% of patients. (1). The rete testis drains into the epididymis via 10 to 15 efferent ductules.There are four testicular appendages (remnants of the mesonephric and paramesonephric ducts): the appendix testis (hydatid of Morgagni), the appendix epididymis, the vas aberrans, and the paradidymis. The appendix testis and the appendix epididymis are commonly seen on scrotal US. The appendix testis is a small ovoid structure usually at the upper pole of the testis in the groove between the testis and the epididymis, better seen by the presence of fluid around the testis.The testes are supplied by testicular arteries that arise from the abdominal aorta. The testicular arteries enter the spermatic cord at the deep inguinal ring and continue along the posterior surface of the testis, penetrating the tunica albuginea and forming the capsular arteries that course through the tunica vasculosa, which underlies the tunica ABDOMINAL IMAGING PICTORIAL ESSAY Imaging of non-neoplastic intratesticular massesShweta Bhatt, Syed Zafar H. Jafri, Neil Wasserman, Vikram S. Dogra ABSTRACTThe u...

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Section: Vascular Lesions Intratesticular Varicocelementioning

confidence: 99%

“…Gray-scale sonography demonstrates tubular or serpentine structures more than 2 mm in diameter with a positive Valsalva maneuver, confirming the venous origin (Fig. 7) (15,17).…”

Section: Vascular Lesions Intratesticular Varicocelementioning

confidence: 99%

Non neoplastic intratesticular masses

Bhatt¹,

Jafri²,

Wasserman³

et al. 2009

Diagn Interv Radiol

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“…The condition was first described by Weiss et al 1 in 1992, and since then, fewer than 50 cases have been reported, mostly in very small series or single case reports. [2][3][4][5][6][7][8][9][10][11][12][13][14] It has been defined sonographically as tubular or oval structures with a diameter of 2 mm or greater in and around the mediastinum testis with venous flow and a positive Valsalva maneuver response. 9 The clinical importance of this condition has not been established yet, but awareness of its appearance on sonography is important to differentiate it from other focal testicular lesions, including malignancy.…”

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confidence: 77%

“…4,5 Intratesticular varicocele, conversely, is a rare and relatively new entity, reported in fewer than 2% of symptomatic men undergoing testicular sonography. [6][7][8][9] Initially, it was thought to be always associated with an ipsilateral ETV; subsequent reports claimed that ITVs are more commonly found alone. In those cases in which the ITVs are a continuation of the ETVs, one may speculate that the 2 entities have a common etiology.…”

Section: Discussionmentioning

confidence: 99%

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Intratesticular Varicocele

Kessler

Meirsdorf

Graif

et al. 2005

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to evaluate the gray scale and color Doppler appearances of intratesticular varicocele (ITV) in a relatively large series of men and to compare the findings with those previously reported. Methods. Fifteen ITVs found in 12 men referred for sonographic examination of a variety of scrotal conditions were retrospectively evaluated. Review of the side, location, shape, and diameter of the dilated veins, the presence of an extratesticular varicocele (ETV), and the color Doppler appearance of the ITV before and during the Valsalva maneuver was performed. Results. Seven (47%) of 15 ITVs were located in the left testis, 2 (13%) in the right, and 3 (20%) bilateral. Eighty-six percent of the ITVs were associated with an ipsilateral ETV. The locations of the ITVs were subcapsular in 60% of the cases and within or near the mediastinum of the testis in 40%. The shapes of the ITVs were tubular in 46%, oval in 27%, and both tubular and oval in the remaining 27%. Color Doppler imaging showed spontaneous flow in 60% of cases, whereas in the remaining 40%, the blood flow could be seen only after the Valsalva maneuver. Conclusions. Intratesticular varicocele is a rare condition with a variable clinical and sonographic appearance. It is usually associated with ETV. It occurs in the left, right, or both testes and may be subcapsular or mediastinal in location. The prevalence of a subcapsular location of ITVs in this series was by far higher than previously mentioned in the literature. The Valsalva maneuver plays a very important role in the diagnosis of ITV because in almost half of cases, the flow will not show up spontaneously. 2-14 It has been defined sonographically as tubular or oval structures with a diameter of 2 mm or greater in and around the mediastinum testis with venous flow and a positive Valsalva maneuver response. 9 The clinical importance of this condition has not been established yet, but awareness of its appearance on sonography is important to differentiate it from other focal testicular lesions, including malignancy.The aim of this study was to describe the gray scale and color Doppler appearances in a relatively large series of men with ITVs and to compare the findings with those previously reported.

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Varicocele and its Role in Male Infertility

Jequier

2000

Male Infertility

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Intratesticular varicocele

Cited by 51 publications

References 8 publications

Non neoplastic intratesticular masses

Non neoplastic intratesticular masses

Intratesticular Varicocele

Varicocele and its Role in Male Infertility

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