Is varicocele associated with underlying venous abnormalities? Varicocele and the prostatic venous plexus

We examined the pampiniform plexus and prostatic venous plexus using color Doppler ultrasonography and evaluated the relationship between varicocele and the prostatic venous plexus.

This study included 209 men with a mean age of 35.3 years, of whom 68 had no varicoceles, 94 had a unilateral varicocele and 47 had bilateral varicoceles based on scrotal color Doppler ultrasonography. The diameter of the pampiniform plexus and prostatic venous plexus was measured using scrotal and transperineal ultrasonography, respectively. Peak retrograde and antegrade flow velocity of the prostatic venous plexus was measured by transperineal color Doppler ultrasonography.

Mean diameter, and peak and antegrade flow velocity of the prostatic venous plexus were greater in men with bilateral varicoceles than in those with a unilateral varicocele and in those without a varicocele (p <0.01). Moreover, men with a unilateral varicocele had a greater mean peak antegrade flow velocity than those without a varicocele (p <0.05). However, mean diameter and peak retrograde flow velocity were not different in men with a unilateral varicocele and those without a varicocele. In 10 men with a left clinical varicocele mean diameter, and peak retrograde and antegrade flow velocity of the prostatic venous plexus did not differ before vs after varicocele repair. In all men the diameter of the prostatic venous plexus positively correlated with the diameter of the right and left pampiniform plexus (p <0.0001).

Varicocele, especially bilateral varicoceles, may be associated with underlying venous abnormalities.