Comparative study between scrotal physical examination and scrotal ultrasonography in the detection of varicocele in men with infertility.

From September 1989 to March 1991, we evaluated 110 men from our infertility clinic to determine the correlation between scrotal physical examination and scrotal ultrasonography in the detection of varicocele in men seeking clinical evaluation for infertility, depicting scrotal ultrasound as the gold standard. Of 110 men with infertility, clinically palpable varicocele was found in 40 patients (36.36%). Fifteen were of grade 1, nineteen of grade 2 and four of grade 3. Of these 40 patients, 32 (80%) had left sided varicocele 2 (5%) had right sided varicocele and the remaining 6 patients (15%) had bilateral varicoceles. Of the 40 patients with clinically palpable varicocele, 34 (85%) had the diagnosis confirmed by scrotal ultrasound. Of these 34 patients who had varicocele diagnosed by scrotal ultrasound, 17 (50%) had varicocele on the left side, 1 (2.94%) had varicocele on the right side and the remaining 16 patients (47.07%) had bilateral varicoceles. Seventy patients in whom initial scrotal physical examination failed to detect varicocele, 12 (17.14%) were found to have varicocele by scrotal ultrasound, all of which were on the left side. This group of patients was classified as subclinical varicocele. Statistical analysis revealed that scrotal physical examination in the detection of clinical varicocele has sensitivity of 73.90 per cent, specificity of 90.60 per cent and positive predictive value of 85.00 per cent with negative predictive value of 82.80 per cent.(ABSTRACT TRUNCATED AT 250 WORDS)