QUANTITATIVE DOPPLER ASSESSMENT OF FLOW CHARACTERISTICS IN PAMPINIFORM VENOUS PLEXUS, IN PATIENTS WITH VARICOCELE: IS THERE ANY RELATIONSHIP WITH SEMEN ANALYSIS?

Abstract

BACKGROUND: Ultrasound is used as the key-tool in diagnosis of varicocele, using vein diameter & venous reflux as diagnostic criteria .This study was aimed to assess the significance of presence of reflux & its quantification in relation to sperm analysis. MATERIALS AND METHOD: In this analytic study; 69 patients with clinical diagnosis of varicocele were examined with Doppler sonography at rest and during Valsalva maneuver in supine position assessing the presence of reflux & quantifying it to reveal any correlations with sperm analysis. X² test and T test were used where appropriate. RESULTS: Overall 29 patients (42%) showed evidences of venous reflux at Doppler ultrasound, with 16 (23%) showing continuous venous reflux during breath-holding. This continuity of reflux of either sides (right or left) was present in 15 (93.8%) with abnormal semen analysis & just 1(6.3%) with normal semen analysis (p=0.001). Right-sided reflux was seen in 9 (13%), left-sided in 29 (42%). Unilateral right-sided reflux was not seen. Left-sided reflux was present in 20 (69%) with abnormal semen analysis and 9 (31%) with normal analysis, representing significant statistical difference between left-sided venous reflux & abnormal semen analysis (p=0.01). Right-sided reflux was seen in 6 patient with abnormal semen analysis and 3 patients with normal semen analysis, with no statistical difference (P=0.47). Patients with normal semen analysis never showed bilateral venous reflux (p=0.02). CONCLUSION: Presence of bilateral venous reflux or continuous venous reflux of either side has significant predictive value for abnormality of semen analysis. Keywords: Varicocele; Doppler ultrasound; Venous reflux; Flow volume.