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Stop-type and shunt-type varicoceles: venographic findings
Radiology
|April 1, 1987
Summary
Doppler ultrasound identified two varicocele types: stop and shunt. Venography confirmed these distinct blood flow patterns, revealing shunt-type varicoceles act as a venous bypass, potentially impacting fertility.
Area of Science:
- Urology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Idiopathic varicocele is a common cause of male subfertility.
- Understanding the hemodynamics of varicocele is crucial for diagnosis and management.
- Previous studies suggested different venous flow patterns in varicoceles.
Purpose of the Study:
- To classify left-sided idiopathic varicoceles based on Doppler ultrasound findings.
- To confirm the hemodynamic differences between varicocele types using venography.
- To investigate the potential prognostic significance of varicocele types in subfertility.
Main Methods:
- Bidirectional Doppler ultrasound (US) examination of 44 patients.
- Physical examination.
- Percutaneous retrograde venography for hemodynamic confirmation.
Main Results:
- Doppler US classified varicoceles into 'stop type' and 'shunt type'.
- Venography confirmed stop-type varicoceles exhibit only retrograde flow in the testicular vein.
- Shunt-type varicoceles demonstrated both retrograde and orthograde flow via collateral veins (deferential, cremasteric).
Conclusions:
- Doppler US effectively differentiates two distinct hemodynamic varicocele types.
- Shunt-type varicoceles function as a venous bypass, a potential precondition for medium/large varicoceles.
- Varicocele type may hold prognostic significance for varicocele-associated subfertility.