[Scrotal scintigraphy in varicocele compared with physical examination and venography]

Scrotal scintigraphy using a gamma-camera and 740 MBq of 99mTc-labeled human serum albumin was performed on 43 patients with suspected varicocele. In 39 patients (37 left-sided, 2 bilateral) with proven varicoceles, sensitivities by the static and dynamic images were 92.3% and 51.3%, respectively. There were no false positive cases in either image (4 cases with no varicocele). It has been suggested that static images are useful for the detection of varicocele in infertile men. A comparison between the static and clinical grades showed that the static grades appeared to become higher in proportion to the clinical grades. A comparison between the static grades and the diameter of the internal spermatic vein (ISV) showed that the mean value of the diameter of the ISV in SG 1, SG 2 and SG 3 was 4.1 +/- 0.66 mm, 5.1 +/- 0.68 mm, and 6.2 +/- 0.79 mm, respectively. Patients with higher static grades had ISVs of significantly larger diameter (SG 1 vs SG 2; p less than 0.05, SG2 vs SG3; p less than 0.01, SG 1 vs SG 3; p less than 0.01, t-test). A comparison between the dynamic images and the degree of reflux in the ISV showed that patients with positive dynamic images had a significantly greater degree of reflux (p less than 0.01, Chi-square test). From these observations, scintigraphic findings would reflect the degree of reflux in the ISV, the diameter of ISV, and the size of the varicocele. Furthermore, from the remarkable changes between pre- and post-therapeutic findings on the scintigrams, therapeutic effects could be easily and objectively assessed by scintigraphy.