Ensheng Xue MD, Presenter: Nothing to Disclose

Liwu Lin MD, Abstract Co-Author: Nothing to Disclose

To investigate the effect of color ultrasonographic grading of varicocele (VC) on the changes of fertility index (FI) before and after varicocelectomy.

A total of 151 patients （18~44 years old） with VC were recruited for this study. All patients were diagnosed and graded by scrotal color Doppler ultrasonography. According to the reflux degree of pampiniform plexus veins (PPV), varicoceles were graded into 3 groups: VCI, VCII and VCIII. High ligation of spermatic vein was performed in all patients and semen analysis was performed before and after varicocelectomy according to WHO guidelines. FI=sperm concentration (106/ml)×sperm viability×sperm normal morphology rate. The changes of FI were analyzed before and after varicocelectomy. Results: The reflux degree of PPV was significantly correlated with the maximum diameter of PPV (r=0.89, P=0.000). Compared before and after high ligation of spermatic vein, the FI was not significant difference in VCI (P=0.361), but was statistically significant difference in VCII (P=0.020) and VCIII (P=0.000). In the patients with the maximum diameter of PPV measured from 2.2 to 2.6 mm, the FI was not significant difference in VCI (P=0.798), but the FI was statistically significant difference in VCII (P=0.038)，before and after varicocelectomy. In the patients with the maximum diameter of PPV < 2.2 mm, the FI was not significantly increased (P=0.301) after varicocelectomy.  

Opportunity of surgical varicocelectomy and evaluation of operative outcome can be determined according to Color Doppler ultrasonographic grading of VC. The grading indexes, combination of the reflux degree of VC and the maximum diameter of PPV, are more reasonable and reliable.

Opportunity of surgical varicocelectomy and evaluation of operative outcome can be determined according to Color Doppler ultrasonographic grading of VC. The grading indexes, combination of the reflux degree of VC and the maximum diameter of PPV, are more reasonable and reliable.

Patients with VC I and the maximum diameter of PPV < 2.2 mm would not have a varicocelectomy.

Xue, E, Lin, L, Effect of Color Ultrasonographic Grading of Varicocele on the Changes of Fertility Index after Varicocelectomy.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6006834.html