Diagnosis of subclinical varicocele in infertility

The clinically obvious varicocele is perhaps the most common identifiable and correctable cause of male infertility. However, less is known about the subclinical (not palpable) varicocele and its relationship to infertility. We undertook this study to compare the ability of high-resolution sonograph...

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Bibliographic Details
Published inAmerican journal of roentgenology (1976) Vol. 148; no. 1; pp. 71 - 75
Main Authors Gonda, RL, Jr, Karo, JJ, Forte, RA, O'Donnell, KT
Format Journal Article Conference Proceeding
LanguageEnglish
Published Leesburg, VA Am Roentgen Ray Soc 01.01.1987
American Roentgen Ray Society
Subjects
Applied sciences
Biological and medical sciences
Birth control
Exact sciences and technology
Gynecology. Andrology. Obstetrics
Humans
Infertility, Male - etiology
Male
Medical sciences
Other techniques and industries
Radionuclide Imaging
Scrotum - diagnostic imaging
Semen - analysis
Sodium Pertechnetate Tc 99m
Sperm Count
Sterility. Assisted procreation
Ultrasonography
Varicocele - complications
Varicocele - diagnosis
Human
Screening
Varicocele
Male sterility
Subfertility
Male genital diseases
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Summary:The clinically obvious varicocele is perhaps the most common identifiable and correctable cause of male infertility. However, less is known about the subclinical (not palpable) varicocele and its relationship to infertility. We undertook this study to compare the ability of high-resolution sonography and radionuclide scrotal scanning to detect subclinical varicocele. Fifty patients who were referred to our department with a diagnosis of infertility, an abnormal semen analysis, and a normal physical examination of the scrotum underwent both sonography and nuclear scanning. The final study group included 20 men who agreed to surgical ligation of the spermatic vein(s) after a positive sonographic and/or radionuclide study. Sonography was considered positive for subclinical varicocele in 95% of patients, while nuclear scanning was considered positive in only 55%. Postoperatively, all patients showed improvement in their semen and 40% (eight patients) became fertile. Subclinical varicocele seems to be an important causal factor in infertility and, in our experience, high-resolution sonography is superior to radionuclide scanning in its diagnosis.
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ISSN:0361-803X
1546-3141
DOI:10.2214/ajr.148.1.71