Koyuncu Hakan, Ergenoglu Mehmet, Yencilek Faruk, Gulcan Nilay, Tasdelen Neslihan, Yencilek Esin, Sarica Kemal
Yeditepe University Medical School, Department of Urology, Istanbul, Turkey.
J Androl. 2011 Mar-Apr;32(2):151-4. doi: 10.2164/jandrol.109.009258. Epub 2010 Mar 4.
The aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele. A total of 70 patients with the primary diagnosis of varicocele were included into the study. A total of 30 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by palpation and observation of each spermatic cord in standing position before and during a valsalva maneuver. Additionally, scrotal Doppler and lower extremity venous Doppler ultrasonography were performed. Patients who were with spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler ultrasonography, a retrograde flow lasting longer than 0.5 seconds during normal breathing or at the valsalva maneuver was considered to be meaningful for saphenofemoral junction insufficiency. Thirty-six (51.35%) patients had insufficiency in saphenofemoral junction in the study group (6 [8.5%] bilateral, 30 [42.85%] unilateral) whereas 8 (26.6%) had insufficiency in the control group (2 [6.6%] bilateral, 6 [20%] unilateral insufficiency). The patients with primary varicocele had a statistically significant (P = .02) higher rate of venous insufficiency in their saphenofemoral junctions when compared with the control group. In the present study, the rate of saphenofemoral insufficiency has been found to be statistically higher in patients with primary varicocele compared with healthy men. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from saphenofemoral junction insufficiency.
本研究的目的是评估诊断为原发性精索静脉曲张的患者中精索静脉曲张与股隐静脉瓣膜功能不全之间的可能关系。共有70例初步诊断为精索静脉曲张的患者纳入本研究。另外，共有30例年龄匹配的健康成年人作为对照组纳入本研究。通过触诊以及在瓦尔萨尔瓦动作前后站立位观察每条精索来诊断精索静脉曲张。此外，还进行了阴囊多普勒和下肢静脉多普勒超声检查。精索静脉曲张内径大于3.0 mm的患者作为精索静脉曲张患者纳入研究组。在下肢静脉多普勒超声检查中，正常呼吸或瓦尔萨尔瓦动作时反流持续时间超过0.5秒被认为提示股隐静脉瓣膜功能不全。研究组中有36例（51.35%）患者存在股隐静脉瓣膜功能不全（双侧6例[8.5%]，单侧30例[42.85%]），而对照组中有8例（26.6%）存在瓣膜功能不全（双侧2例[6.6%]，单侧6例[20%]）。与对照组相比，原发性精索静脉曲张患者股隐静脉瓣膜功能不全的发生率具有统计学意义（P = 0.02）的升高。在本研究中，发现原发性精索静脉曲张患者股隐静脉瓣膜功能不全的发生率与健康男性相比具有统计学意义的升高。基于瓣膜功能不全的普遍存在，我们认为对于患有股隐静脉瓣膜功能不全的年轻人群，应调查其是否存在精索静脉曲张。
