Doppler sonographic evaluation of varicoceles / Avaliação ultrassonográfica ao duplex Doppler colorido da varicocele

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

INTRODUCTION: Varicocele is the dilatation of the veins of the pampiniform plexus of the testicle. The association between varicocele and infertility is diagnosed in 20 to 40% of the infertile men. Currently, in the ultrasound study of varicocele, the diameter of the veins is carried through with the patient in the supine position, before and during the Valsalva maneuver, taking the diameter of the veins consideration (>0,20cm), and a more than 1 second bigger presence of reflux according to spectral Doppler study. OBJECTIVE: A) To consider a new methodology in the ultrasonographic evaluation of varicocele. B) To evaluate the agreement of the findings in the colorful Doppler ultrasonographic examination of the pampiniform plexus vases with the alterations in the spermogram in masculine infertility. C) To evaluate the correlation between the diameter of one the pampiniform plexus vases and the alterations in the spermogram in the masculine infertility. METHODS: 266 patients from the reproduction sector human being of the Hospital of the Clinics of the University of São Paulo (HCUSP) had been examined, by means of colorful duplex-Doppler, initially with the patient in dorsal decubitus and later, after 5 minutes, in the orthostatic position, carrying through the transversal measures of the diameter of the pampiniform plexus in the two positions, in rest and in Valsalva. To the pulse study reflux was considered pathological only when persisted for more than 1 second, with speed superior to 2 cm/s. These patients were also submitted to seminal analysis. RESULTS: Regarding the methodology of accomplishment of the examination, an increase in the diameter of pampiniform plexus was noted only with the variation of the examination position, about 18% to the right and 5,9% to the left, as well as an increase in the detection of venous reflux in the orthostatic position, 23% to right and 6,8% to the left. It was also detected a correct correlation between variations in the spermogram and the venous reflux, 65% to the right and 86% to the left, the same not occurring with the diameter of pampiniform plexus. CONCLUSIONS: A) The colorful Doppler ultrasound examination must be carried through in the orthostatic position, after a period of latency of at least five minutes, with comfortable environement conditions and effort maneuver. B) A significant accordance between the pampiniform plexus venous reflux and the alterations of the spermogram. C) It does not have significant correlation between the diameter of one of the pampiniform plexus vases and the spermogram

ASSUNTO(S)

duplex doppler ultrasonography espermograma infertilidade masculina varicocele ultrasonografia color doppler masculine infertility exames médicos/método varicocele ultrasonographic examination methodology spermogram

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