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Abstract

Varicocele is clinically defined as an abnormal dilatation of the veins of the pampiniform plexus with continuous or intermittent reflux of the venous blood. It is actually considered the most common correctable cause of male infertility, even though the mechanisms responsible for infertility are still unclear. The prevalence of this disorder in the general population is approximately 15–20 % [1], and it is involved in up to 40 % of cases of men infertility [2–4].

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References

  1. Meacham RB, Townsend RR, Rademacher D et al (1994) The incidence of varicoceles in the general population when evaluated by physical examination, gray scale sonography and color Doppler sonography. J Urol 151:1535–1538

    CAS  PubMed  Google Scholar 

  2. Carlsen E, Andersen AG, Buchreitz L et al (2000) Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size. Int J Androl 23:248–253

    Article  CAS  PubMed  Google Scholar 

  3. Naughton CK, Nangia AK, Agarwal A (2001) Pathophysiology of varicoceles in male infertility. Hum Reprod Update 7:473–481

    Article  CAS  PubMed  Google Scholar 

  4. Shafik A, Moftah A, Olfat S et al (1990) Testicular veins: anatomy and role in varicocelogenesis and other pathologic conditions. Urology 35:175–182

    Article  CAS  PubMed  Google Scholar 

  5. Dubin L, Amelar RD (1970) Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril 21:606–609

    Article  CAS  PubMed  Google Scholar 

  6. Beddy P, Geoghegan T, Browne RF et al (2005) Testicular varicoceles. Clin Radiol 60:1248–1255

    Article  CAS  PubMed  Google Scholar 

  7. Liguori G, Trombetta C, Garaffa G et al (2004) Color Doppler ultrasound investigation of varicocele. World J Urol 22:378–381

    Article  PubMed  Google Scholar 

  8. Hargreave TB, Liakatas J (1991) Physical examination for varicocele. Br J Urol 67:328

    Article  CAS  PubMed  Google Scholar 

  9. Comparison among different methods for the diagnosis of varicocele (1985) World health organization task force on the diagnosis and treatment of infertility. Fertil Steril 43:575–582

    Google Scholar 

  10. Niedzielski J, Paduch D, Raczynski P (1997) Assessment of adolescent varicocele. Pediatr Surg Int 12:410–413

    Article  CAS  PubMed  Google Scholar 

  11. Sarteschi LM, Paoli R, Bianchini M et al (1993) Lo studio del varicocele con eco-color Doppler. G Ital Ultrasonologia 4:43–49

    Google Scholar 

  12. Chiou RK, Anderson JC, Wobig RK et al (1997) Color Doppler ultrasound criteria to diagnose varicoceles: correlation of a new scoring system with physical examination. Urology 50:953–956

    Article  CAS  PubMed  Google Scholar 

  13. Dogra VS, Gottlieb RH, Oka M et al (2003) Sonography of the scrotum. Radiology 227:18–36

    Article  PubMed  Google Scholar 

  14. Pearl MS, Hill MC (2007) Ultrasound of the scrotum. Semin Ultrasound CT MR 28:225–248

    Article  PubMed  Google Scholar 

  15. Gonda RL Jr, Karo JJ, Forte RA et al (1987) Diagnosis of subclinical varicocele in infertility. AJR Am J Roentgenol 148:71–75

    Article  PubMed  Google Scholar 

  16. Jarow JP (2001) Effects of varicocele on male fertility. Hum Reprod Update 7:59–64

    Article  CAS  PubMed  Google Scholar 

  17. Sakamoto H, Ogawa Y, Yoshida H (2008) Relationship between testicular volume and varicocele in patients with infertility. Urology 71:104–109

    Article  PubMed  Google Scholar 

  18. Marks JL, McMahon R, Lipshultz LI (1986) Predictive parameters of successful varicocele repair. J Urol 136:609–612

    CAS  PubMed  Google Scholar 

  19. Sigman M, Jarow JP (1997) Ipsilateral testicular hypotrophy is associated with decreased sperm counts in infertile men with varicoceles. J Urol 158:605–607

    Article  CAS  PubMed  Google Scholar 

  20. Zini A, Buckspan M, Berardinucci D et al (1997) The influence of clinical and subclinical varicocele on testicular volume. Fertil Steril 68:671–674

    Article  CAS  PubMed  Google Scholar 

  21. Alukal JP, Zurakowski D, Atala A et al (2005) Testicular hypotrophy does not correlate with grade of adolescent varicocele. J Urol 174:2367–2370; discussion 2370

    Article  PubMed  Google Scholar 

  22. Callea A, Berardi B, Dilorenzo V et al (1997) Echo-color doppler in the topographic study of varicocele. Arch Ital Urol Androl 69:189–192

    CAS  PubMed  Google Scholar 

  23. Aydos K, Baltaci S, Salih M et al (1993) Use of color Doppler sonography in the evaluation of varicoceles. Eur Urol 24:221–225

    CAS  PubMed  Google Scholar 

  24. Eskew LA, Watson NE, Wolfman N et al (1993) Ultrasonographic diagnosis of varicoceles. Fertil Steril 60:693–697

    Article  CAS  PubMed  Google Scholar 

  25. Lund L, Nielsen AH (1994) Color Doppler sonography in the assessment of varicocele testis. Scand J Urol Nephrol 28:281–285

    CAS  PubMed  Google Scholar 

  26. Tasci AI, Resim S, Caskurlu T et al (2001) Color doppler ultrasonography and spectral analysis of venous flow in diagnosis of varicocele. Eur Urol 39:316–321

    Article  CAS  PubMed  Google Scholar 

  27. Winkelbauer FW, Ammann ME, Karnel F et al (1994) Doppler sonography of varicocele: long-term follow-up after venography and transcatheter sclerotherapy. J Ultrasound Med 13:953–958

    Article  CAS  PubMed  Google Scholar 

  28. Petros JA, Andriole GL, Middleton WD et al (1991) Correlation of testicular color Doppler ultrasonography, physical examination and venography in the detection of left varicoceles in men with infertility. J Urol 145:785–788

    CAS  PubMed  Google Scholar 

  29. Hoekstra T, Witt MA (1995) The correlation of internal spermatic vein palpability with ultrasonographic diameter and reversal of venous flow. J Urol 153:82–84

    Article  CAS  PubMed  Google Scholar 

  30. Hirsh AV, Cameron KM, Tyler JP et al (1980) The Doppler assessment of varicoceles and internal spermatic vein reflux in infertile men. Br J Urol 52:50–56

    Article  CAS  PubMed  Google Scholar 

  31. Oyen RH (2002) Scrotal ultrasound. Eur Radiol 12:19–34

    Article  PubMed  Google Scholar 

  32. Cornud F, Belin X, Amar E et al (1999) Varicocele: strategies in diagnosis and treatment. Eur Radiol 9:536–545

    Article  CAS  PubMed  Google Scholar 

  33. Iosa G, Lazzarini D (2013) Hemodynamic classification of varicoceles in men: our experience. J Ultrasound 16(2):57–63

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Gat Y, Bachar GN, Zukerman Z et al (2004) Varicocele: a bilateral disease. Fertil Steril 81:424–429

    Article  PubMed  Google Scholar 

  35. Sarteschi LM, Liguori G, Trombetta C (2003) Varicocele. In: Sarteschi LM, Menchini-Fabris GF (eds) Ecografia andrologica, 1st edn. Athena Srl, Modena, pp 139–155

    Google Scholar 

  36. Shlansky-Goldberg R et al (1997) Percutaneous varicocele embolization versus surgical ligation for the treatment of infertility: changes in seminal parameters and pregnancy outcomes. J Vasc Interv Radiol 8:759–767

    Article  CAS  PubMed  Google Scholar 

  37. Shiraishi K, Naito K, Takihara H (2003) Indication of varicocelectomy in the era of assisted reproductive technology: prediction of treatment outcome by noninvasive diagnostic methods. Arch Androl 49:475–478

    Article  CAS  PubMed  Google Scholar 

  38. Hussein AF (2006) The role of color Doppler ultrasound in prediction of the outcome of microsurgical subinguinal varicocelectomy. J Urol 176:2141–2145

    Article  PubMed  Google Scholar 

  39. Liguori G, Ollandini G, Pomara G et al (2010) Role of renospermatic basal reflow and age on semen quality improvement after sclerotization of varicocele. Urology 75:1074–1078

    Article  PubMed  Google Scholar 

  40. Atasoy C, Fitoz S (2001) Gray-scale and color Doppler sonographic findings in intratesticular varicocele. J Clin Ultrasound 29:369–373

    Article  CAS  PubMed  Google Scholar 

  41. Weiss AJ, Kellman GM, Middleton WD et al (1992) Intratesticular varicocele: sonographic findings in two patients. AJR Am J Roentgenol 158:1061–1063

    Article  CAS  PubMed  Google Scholar 

  42. Ozcan H, Aytac S, Yagci C et al (1997) Color Doppler ultrasonographic findings in intratesticular varicocele. J Clin Ultrasound 25:325–329

    Article  CAS  PubMed  Google Scholar 

  43. Das KM, Prasad K, Szmigielski W et al (1999) Intratesticular varicocele: evaluation using conventional and Doppler sonography. AJR Am J Roentgenol 173:1079–1083

    Article  CAS  PubMed  Google Scholar 

  44. Abduljaleel PM, Al-Mulhim F, Nouman A et al (2006) Intratesticular varicocele and extratesticular varicocele in a patient with nephrotic syndrome complicated by left renal vein thrombosis. Ann Saudi Med 26:228–230

    PubMed  Google Scholar 

  45. Mehta AL, Dogra VS (1998) Intratesticular varicocele. J Clin Ultrasound 26:49–51

    Article  CAS  PubMed  Google Scholar 

  46. DemIrbas M, Ellergezen A, CY BI et al (2001) Intratesticular varicocele treated with percutaneous embolization. Urology 58:1058

    Article  CAS  PubMed  Google Scholar 

  47. Tetreau R, Julian P, Lyonnet D et al (2007) Intratesticular varicocele: an easy diagnosis but unclear physiopathologic characteristics. J Ultrasound Med 26:1767–1773

    Article  PubMed  Google Scholar 

  48. Morvay Z, Nagy E (1998) The diagnosis and treatment of intratesticular varicocele. Cardiovasc Intervent Radiol 21:76–78

    Article  CAS  PubMed  Google Scholar 

  49. Diamond DA, Roth JA, Cilento BG et al (2004) Intratesticular varicocele in adolescents: a reversible anechoic lesion of the testis. J Urol 171:381–383

    Article  PubMed  Google Scholar 

  50. Bucci S, Liguori G, Amodeo A et al (2008) Intratesticular varicocele: evaluation using grey scale and color Doppler ultrasound. World J Urol 26:87–89

    Article  PubMed  Google Scholar 

  51. Conti E, Fasolo PP, Sebastiani G et al (2005) Color Doppler sonography in the intratesticular varicocele. Arch Ital Urol Androl 77:63–65

    PubMed  Google Scholar 

  52. O’Donnell PG, Dewbury KC (1998) The ultrasound appearances of intratesticular varicocele. Br J Radiol 71:324–325

    Article  PubMed  Google Scholar 

  53. Erdogan N, Ekmekcioglu O, Baykara M (2003) Bilateral intratesticular varicocele in a patient with a history of bilateral cryptorchidism. Turk J Med Sci 33:117–119

    Google Scholar 

  54. Dee KE, Deck AJ, Waitches GM (2000) Intratesticular pseudoaneurysm after blunt trauma. AJR Am J Roentgenol 174:1136

    Article  CAS  PubMed  Google Scholar 

  55. Yilmaz C, Arslan M (2009) Intrascrotal arteriovenous malformation simulating varicocele. AJR Am J Roentgenol 192:W351

    Article  PubMed  Google Scholar 

  56. Bhatt S, Rubens DJ, Dogra VS (2006) Sonography of benign intrascrotal lesions. Ultrasound Q 22:121–136

    Article  PubMed  Google Scholar 

  57. Graif M, Hauser R, Hirshebein A et al (2000) Varicocele and the testicular-renal venous route: hemodynamic Doppler sonographic investigation. J Ultrasound Med 19:627–631

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Giovanni Liguori MD, PhD .

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Liguori, G. et al. (2017). Varicocele. In: Martino, P., Galosi, A. (eds) Atlas of Ultrasonography in Urology, Andrology, and Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-319-40782-1_42

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  • DOI: https://doi.org/10.1007/978-3-319-40782-1_42

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