Sequential scrotal scintigraphy for the study of varicocele

Scrotal scintigraphy is a non-invasive procedure for evaluating spermatic vein reflux. This technique was used in 43 infertile patients with varicocele. None of them had infections, traumatic, or chromosomal abnormalities that could be associated with their infertility. Twelve patients showed type 1 time activity curve, including 3 with grade II, and 9 with grade III varicocele. A total of 12 patients showed a type 2 pattern and consisted of 2 patients with grade I, 6 with grade II, and 4 with grade III varicocele. Nineteen showed type 3 pattern consisting of 6 with grade I, 6 with grade II, and 7 with grade III. The patients with grade III varicocele showed type 1 pattern more frequently than those with grade I or II (p<0.05). Preoperative sperm concentration in patients with grade I varicocele was significantly lower than that in patients with grade II or III disease (p<0.05, each). Sperm motility of patients with grade I varicocele was also significantly lower than that of those with grade II or III varicocele (p<0.01, each). Patients with grade II or III varicocele showed an increase in sperm concentration postoperatively, and those with grade I varicocele showed a postoperative increase in sperm motility, but the differences between pre- and postoperative values were not significant. While seminal findings in patients with type 2 or 3 pattern did not change after surgery, patients with type 1 pattern showed significant improvement in sperm concentration postoperatively (p<0.05). It is concluded that preoperative sequential scrotal scintigraphy can be a more useful technique for assessing the prognosis for postoperative improvement of seminal findings than the grade decision of varicocele.