[Subclinical varicocele: detection using Doppler and thermography]

Area of Science:

• Urology
• Andrology
• Reproductive Medicine

Background:

• Varicocele is a common cause of male infertility.
• Oligospermia, asthenospermia, and teratospermia are key indicators of impaired sperm quality.
• Subclinical varicoceles may negatively impact sperm parameters.

Purpose of the Study:

• To investigate the necessity of varicocele detection in cases of abnormal sperm parameters.
• To evaluate the efficacy of Doppler ultrasound with Valsalva maneuver for diagnosing subclinical varicoceles.
• To assess the prognostic value of bursae thermography in predicting spermogramme evolution post-varicocele treatment.

Main Methods:

• Clinical examination for varicocele.
• Doppler ultrasound with Valsalva maneuver to provoke venous backflow.
• High ligature of the left spermatic vein for treatment.
• Bursae thermography for prognostic assessment.

Main Results:

• A high incidence of varicocele is suspected in patients with oligospermia, asthenospermia, and teratospermia, especially with spindle-shaped spermatozoa.
• Valsalva maneuver during Doppler examination is crucial for detecting subclinical varicoceles.
• High ligature of the left spermatic vein is indicated for positive Doppler findings.
• Bursae thermography appears to have prognostic value for spermogramme improvement after treatment.

Conclusions:

• Varicocele should be actively sought in infertile men with abnormal sperm parameters.
• Doppler ultrasound with Valsalva maneuver is essential for diagnosing subclinical varicoceles.
• Surgical correction of varicocele, guided by diagnostic imaging, can improve sperm quality, with thermography offering prognostic insights.