Varicocele testis evaluated by CT-scanning

To evaluate and depict CT-scanning of the spermatic cord in seven men with varicocele testis, during quiet breathing and during Valsalva's manoeuvre. With the patients supine, two transverse scans were made during quiet breathing and two with the intra-abdominal pressure increased by a Valsalva manoeuvre. The transsectional area of the spermatic cord varied between 80 and 100 mm2 on the normal sides and between 100 and 200 mm2 on the affected sides. Raised intra-abdominal pressure dilated the veins of the pampiniform plexus, increasing the trans-sectional area by 40-80% on the normal sides and by 100 to 200% on the affected sides. A spermatic cord area as measured at the root of the scrotum of more than 100 mm2 without raised intra-abdominal pressure, and more than 200 mm2 with, signals a varicocele. CT-scanning with raised intra-abdominal pressure can be used as a safe and non-invasive method to detect a varicocele testis and to show its proximal extension into the inguinal canal. We would also recommend this investigation in patients with unexplained groin pain.