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Updated: Jun 10, 2026
04:15
Combined Supine and Standing Imaging for Varicocele: An Improved Diagnostic Approach
Published on: November 22, 2024
Varicocele and nutcracker syndrome: sonographic findings
Afshin Mohammadi1, Afshin Mohamadi, Mohammad Ghasemi-Rad
1Department of Radiology, Urmia University of Medical Sciences, Urmia, West-Azerbaijan, Iran.
Summary
Nutcracker syndrome is common in varicocele patients, suggesting a link between left renal vein anatomy and varicocele development. Routine screening for nutcracker syndrome is recommended in varicocele diagnosis.
Area of Science:
- Vascular Surgery
- Urology
- Radiology
Background:
- Varicocele, a common cause of male infertility, has an incompletely understood etiology.
- Intrinsic anatomical variations and nutcracker syndrome are potential contributing factors.
Purpose of the Study:
- To investigate the correlation between varicocele and intrinsic anatomical differences in the left renal vein (LRV).
- To determine the prevalence of nutcracker syndrome in patients with varicocele.
Main Methods:
- Sonographic evaluation of the LRV's hilar and aortomesenteric portion (AMP) in 93 varicocele patients and 76 controls.
- Measurement of anteroposterior diameter and peak flow velocity in the LRV.
Main Results:
- Nutcracker syndrome was identified in 30.10% of varicocele patients versus 2.63% of controls.
- Significant differences in LRV diameter and peak flow velocity were observed in varicocele patients.
- Patients with varicocele and nutcracker syndrome showed significantly higher peak flow velocities in the LRV.
Conclusions:
- Nutcracker syndrome is a frequent finding in varicocele patients and should be considered in its diagnosis.
- Intrinsic anatomical differences in the LRV's AMP and hilar portion may directly cause varicocele.
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