The correlation of clinical, laboratory and Doppler ultrasound findings in varicocele patients with infertility

Varicocele is defined as the abnormal tortuosity and dilatation of testicular veins and pampiniform plexus and is characterized by retrograde flow in the affected veins. Etiopathogenesis is not completely understood and is the most frequent curable cause of male infertility. Physical examination is the first diagnostic tool for the diagnosis of varicocele. Ultrasound and Doppler ultrasound are non-invasive, practical and reliable methods in the diagnosis of varicocele. However, the sonographic criteria are not clear. There are conflicting studies on testicular arterial parameters, semen parameters, hormonal values and testis volume in patients with varicocele.This study aimed to correlate sonographic findings with physical examination and to evaluate semen parameters, hormonal values, testicular volume, and resistivity and pulsatility indices of testicular arteries in the diagnosis of varicocele.The study included 100 patients who were diagnosed with a varicocele. In addition, with the control group consisted of 20 healthy subjects. After the history and physical examination of the patient group was done, semen analysis and laboratory findings were evaluated.While some groups showed significant differences in sperm parameters and testicular volume, some groups did not differ. There was no significant difference in testicular arteries except for two parameters. FSH and testosterone levels were normal in most cases.As a result, we found that physical examination is correlated with the sonographic findings. Sonographic examination of the maximum vein diameter, the presence of reflux flow, duration, speed or volume of reflux should be stated in the report. Large series studies are needed to determine objective criteria.Keywords: Varicocele, physical examination, Doppler US, testicular volume, sperm parameters