Hoekstra T, Witt M A
Department of Surgery, Emory University, Atlanta, Georgia.
J Urol. 1995 Jan;153(1):82-4. doi: 10.1097/00005392-199501000-00029.
A gold standard that defines the presence of a subclinical varicocele does not exist. No one has accurately demonstrated at what diameter an internal spermatic vein becomes palpable. We correlated the clinical examination of the scrotum with ultrasonographic measurements of internal spermatic vein diameter and reversal of venous flow in 156 testicles. The internal spermatic vein became palpable at diameters of 3.0 to 3.5 mm. Reversal of flow was found in all veins larger than 3.5 mm. and did not occur in any veins smaller than 2.5 mm. In veins with diameters of 2.5 to 3.5 mm. neither palpability nor internal spermatic vein diameter correlated with the reversal of flow by duplex Doppler color ultrasound. If the internal spermatic vein is nonpalpable during the diagnostic evaluation of the infertile man we do not advocate further radiographic studies. If the palpability of the internal spermatic vein is questionable duplex Doppler color ultrasound is indicated.
目前尚无定义亚临床精索静脉曲张存在的金标准。没有人能准确证明精索内静脉直径达到多少时可被触及。我们将156个睾丸的阴囊临床检查结果与精索内静脉直径的超声测量结果以及静脉血流反流情况进行了关联分析。精索内静脉直径在3.0至3.5毫米时可被触及。在所有直径大于3.5毫米的静脉中均发现有血流反流，而直径小于2.5毫米的静脉中未出现血流反流。对于直径在2.5至3.5毫米的静脉，触诊情况和精索内静脉直径与双功多普勒彩色超声检测的血流反流均无关联。如果在不育男性的诊断评估中精索内静脉不可触及，我们不主张进一步进行影像学检查。如果精索内静脉的可触知性存疑，则应进行双功多普勒彩色超声检查。
