[Volocimetric evaluation of spermatic vessels with echo color doppler in patients with idiopathic varicocele].

BACKGROUND AND AIMS: There is a high incidence of varicocele or dilatation of the spermatic vessels associated with reflux in the male population varying, according to statistics, from 4.5 to 30.7%. Among the numerous hypotheses put forward to explain infertility in approximately 50% of patients with varicocele, it has recently been shown that there is an increased concentration of noradrenalin in the spermatic vessel which might be responsible for chronic arterial vasoconstriction affecting the gonads, leading to endothelial hyperplasia and consequent infertility.

MATERIALS AND

METHODS

In this study the authors have evaluated the bilateral flow of spermatic arteries at the level of the scrotum in patients with varicocele and in the healthy (varicocele-free) population with normal and hypospermatogenesis.

RESULTS

In all groups and in the absence of other major pathologies (including arterial hypertension), no significant differences were found in systolic peak velocity (SPV) in relation to the presence or otherwise of varicocele and the degree of reflux. Mean SPV ranged between 3.5 and 4 cm/sec in patients with hypo- and/or normal zoospermia both in the varicocele and healthy population.

CONCLUSIONS

In line with other authors, we feel that despite the lack of substantial differences in arterial flow in the patients examined, it is not possible at present to explore the testicular microcirculation and possible hypoperfusion using eco color-Doppler, in spite of the fact that the method shows a high level of diagnostic accuracy in the diagnosis of phlogistic pathologies and/or twisting of the spermatic cord. New approaches might be provided through the improved study of the microcirculation using power Doppler which appears to be more sensitive than eco color-Doppler in visualizing small intraparenchymal vessels.