Spermatic vein Doppler examination: use and abuse

Varicoceles have been shown to be detrimental to spermatogenesis and to cause male infertility. Patients with infertility referred for spermatic vein Doppler ultrasound evaluation were studied prospectively to correlate the findings on physical examination and those on Doppler ultrasound evaluation. Twelve out of thirty-four spermatic veins (35%) with no evidence of varicocele on physical examination were found to have definite reflux on Doppler ultrasound examination, while all the unoperated spermatic veins with clinically evident varicoceles had reflux on Doppler ultrasound examination. In the absence of newer methods of diagnosis like high resolution real-time scrotal ultrasonography or scrotal colour Doppler duplex ultrasonography, our results support the use of Doppler ultrasound to detect subclinical varicoceles in patients with infertility but we do not recommend its use in patients with clinically evident varicoceles.