[Intravascular pressure measurements and phlebography of the renal vein: a contribution to the etiology of varicocele].
Phlebography of the left renal vein was performed in 80 patients with left-sided varicocele demonstrating the nutcracker phenomenon. In 39 cases we could prove a compression of the left renal vein. In 10 varicocele patients additional intravascular pressure measurements were studied in both renal veins in the supine and erect position. We found no significant difference between the pressure in the left and right renal vein in the supine position: values varied with respiration. Changing from the supine to the erect position one can note a significantly elevated pressure, higher on the left side than on the right side due to the longer excursion of the left kidney. Urine investigations were done in 153 patients before and in 191 after sclerotherapy to detect protein or blood. Only in 4 patients we found proteinuria but no microhematuria. The results suggest that the aetiology of the varicocele formation is not the nutcracker phenomenon or renal vein hypertension; the predominant cause is a congenital incompetence of the valves in the left testicular vein. The driving force for the retrograde blood flow from the left renal vein into the testicular vein was the increase in pressure: in the supine position caused by respiration, the continuous reflux in the erect position caused by the hydrostatic pressure. The varicocele does not cause a congested kidney with hematuria and proteinuria.
Dermatologische Abteilung, Bundeswehrkrankenhauses Ulm.
H
H
Gall
G
G
Rudofsky
W
W
Bähren
J
J
Roth
J E
JE
Altwein
D006801:Humans; D008297:Male; D011859:Radiography; D012082:Renal Veins / Q000000981:diagnostic imaging*; D013737:Testis / Q000098:blood supply; D014646:Varicocele / Q000000981:diagnostic imaging / Q000209:etiology*; D014680:Veins / Q000002:abnormalities; D014689:Venous Insufficiency / Q000000981:diagnostic imaging; D014690:Venous Pressure
Intravasale Druckmessungen und Phlebographie der Vena renalis: Ein Beitrag zur Atiologie der Varikozele.