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Children and adults varicocele: diagnostic issues and therapeutical strategies

Massimo Valentino1, Michele Bertolotto2, Lorenzo Derchi3

  • 1Radiology Unit, S. Antonio Hospital, via Morgagni 18, 33028 Tolmezzo (Udine), Italy.

Journal of Ultrasound
|September 2, 2014
PubMed

Insights

Varicocele, or dilated scrotal veins, affects 15% of men and causes male infertility. Color-Doppler ultrasonography (US) is the preferred diagnostic tool for varicocele, guiding treatment decisions.

Area of Science:

  • Urology
  • Radiology
  • Andrology

Background:

  • Varicocele, characterized by abnormally dilated scrotal veins, affects 15% of the general male population and up to 40% of infertile males.
  • The pathophysiology of varicocele remains incompletely understood, leading to challenges in establishing definitive diagnostic criteria and treatment indications for asymptomatic individuals.
  • Accurate assessment of testicular volume, vein diameter, and testicular growth in adolescents is crucial, with ultrasonography (US) being the optimal method.

Purpose of the Study:

  • To review the diagnostic utility of ultrasonography, particularly color-Doppler US, in the detection and classification of varicocele.
  • To discuss the current understanding of varicocele pathophysiology and its implications for diagnosis and treatment.
  • To evaluate the effectiveness of various varicocele treatment modalities and their associated outcomes.

Main Methods:

  • Review of existing literature on varicocele diagnosis and treatment.
  • Emphasis on the role of ultrasonography (US) and color-Doppler US in varicocele assessment.
  • Analysis of different surgical and radiological treatment techniques.

Main Results:

  • Color-Doppler US is the method of choice for detecting spermatic vein reflux and grading varicoceles.
  • Color-Doppler US and spectral analysis are effective non-invasive methods for detecting subclinical varicocele linked to infertility.
  • No consensus exists regarding the most effective treatment technique (open surgery, laparoscopy, interventional radiology) for varicocele.

Conclusions:

  • Color-Doppler US is a reliable and accessible method for diagnosing and classifying varicoceles caused by venous reflux.
  • Varicocelectomy plays a significant role in managing adult male infertility associated with varicocele.
  • Further research is needed to clarify pathophysiology and standardize treatment guidelines.

Keywords:
Color-DopplerTestisUltrasonographyVaricocele

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