The Evaluation of Saphenofemoral Insufficiency in Primary Adult Varicocele

Abstract

The aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele. A total of 70 patients with the primary diagnosis of varicocele were included into the study. A total of 30 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by palpation and observation of each spermatic cord in standing position before and during a valsalva maneuver. Additionally, scrotal Doppler and lower extremity venous Doppler ultrasonography were performed. Patients who were with spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler ultrasonography, a retrograde flow lasting longer than 0.5 seconds during normal breathing or at the valsalva maneuver was considered to be meaningful for saphenofemoral junction insufficiency. Thirty-six (51.35%) patients had insufficiency in saphenofemoral junction in the study group (6 [8.5%] bilateral, 30 [42.85%] unilateral) whereas 8 (26.6%) had insufficiency in the control group (2 [6.6%] bilateral, 6 [20%] unilateral insufficiency). The patients with primary varicocele had a statistically significant (P 5 .02) higher rate of venous insufficiency in their saphenofemoral junctions when compared with the control group. In the present study, the rate of saphenofemoral insufficiency has been found to be statistically higher in patients with primary varicocele compared with healthy men. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from saphenofemoral junction insufficiency.

Analysis of testicular‐internal spermatic vein variation and the recreation of varicocoele in a Sprague‐Dawley rat model

“…Approximately 15% of adult males suffer from clinical varicocoele, and 50–80% of these males have subclinical varicocoele (Zini et al ., ). Several theories have been proposed to explain the adverse effects of varicocoele, which include reduced homolateral testicular volume, impaired sperm production ranging from oligozoospermia to complete azoospermia and reduced fertility (Zini et al ., ; Benoff & Gilbert, ; Jarow, ; Marmar, ; Naughton et al ., ; Koyuncu et al ., ). However, how varicocoele affects spermatogenesis in the testis is poorly understood despite considerable research in this area (Balci et al ., ).…”

Editorial Comment from Dr Li to Varicocele is associated with varicose veins: A population‐based case–control study

“…1 Canales et al reported that the prevalence of varicocele in elderly men was greater than that of young control subjects. 2 However, our previous study showed that there are more newly-diagnosed cases of varicocele in patients aged 19-39 years compared with other age groups. 3 Subjects in this age group might have a higher rate of fertility problems and more chance of strenuous exercise, and are therefore more likely to seek medical attention, and older men do not care as much about the fertility issue and might have a higher incidence of asymptomatic varicocele.…”

“…However, the association between varicose veins and varicocele is still controversial. Koyuncu et al 2 and Kilic ß et al 1 showed that the prevalence of peripheral varicose veins was significantly higher in patients with varicocele than those without varicocele. In contrast, in a study of 100 participants, Yazici et al found no statistical relationship between the two conditions.…”

Varicocoele and saphenofemoral reflux: are they coincidentally related?

“…In another series performed in 70 adult varicocoele patients and 30 age‐matched healthy controls, Koyuncu et al. [11] reported a statistically significant relation between varicocoele and SFJ insufficiency and suggested that this proposition must be evaluated with larger series to confirm the possible relation between these two pathological conditions.…”