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Varicocele: strategies in diagnosis and treatment

F Cornud1, X Belin, E Amar

  • 1Service de Radiologie, Hôpital Necker, 149 rue de Sèvres, F-75015 Paris, France.

European Radiology
|March 23, 1999
PubMed

Insights

Diagnosing subclinical varicoceles is challenging. This review explores ultrasonography for detecting flow reversal in spermatic veins and discusses embolization as a treatment alternative to surgery for male infertility.

Area of Science:

  • Reproductive Medicine
  • Urology
  • Medical Imaging

Background:

  • Varicocele, a common cause of male infertility, is often diagnosed via physical examination.
  • Assessing low-grade or questionable varicoceles can be difficult without imaging, complicating treatment decisions for hypofertile men.
  • A definitive gold standard for diagnosing subclinical varicocele remains elusive.

Purpose of the Study:

  • To review diagnostic tools, particularly ultrasonography, for identifying subclinical varicoceles.
  • To emphasize the detection of flow reversal in incontinent spermatic veins.
  • To present experiences and literature on spermatic vein embolization as a treatment alternative.

Main Methods:

  • Review of diagnostic ultrasonography techniques for varicocele assessment.
  • Analysis of flow reversal in spermatic veins using imaging modalities.
  • Literature review and presentation of clinical experience with spermatic vein embolization.

Main Results:

  • Ultrasonography offers various methods to detect flow reversal, aiding in subclinical varicocele diagnosis.
  • Subclinical varicoceles present diagnostic challenges due to difficulties in palpation and assessment.
  • Spermatic vein embolization is presented as a viable alternative to surgical treatment for varicoceles.

Conclusions:

  • Accurate diagnosis of subclinical varicocele is crucial for effective infertility management.
  • Ultrasonography plays a key role in identifying subtle varicoceles.
  • Embolization offers a minimally invasive option for varicocele treatment.

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