[Relationship between ultrasonographic grading of varicocele and changes of seminal parameters after varicocelectomy].
OBJECTIVE
To discuss the correlation of ultrasonographic grading of varicocele (VC) with the changes of seminal parameters after varicocelectomy.


METHODS
A total of 129 cases of VC were diagnosed by scrotal color Doppler ultrasonography (CDU) and graded into 3 groups: VC I, VC II and VC III, according to three different grading indexes: the regurgitant volume of pampiniform plexus veins (PPV), the maximum diameter of PPV and the combination of the regurgitant volume and the maximum diameter of PPV. All the patients underwent high ligation of the spermatic vein and semen analysis was performed before and after varicocelectomy according to the WHO guidelines.


RESULTS
With the maximum diameter of PPV as the grading index, there were statistically significant differences in the seminal parameters of VC III (P < 0.05) but not in those of VC I and VC II (P > 0.05) before and after varicocelectomy, while based on the regurgitant volume of PPV or the combination of the regurgitant volume and the maximum diameter of PPV, the differences were insignificant in VC I (P > 0.05), significant in VC II (P < 0.05) and extremely significant in VC III (P < 0.01). No significant differences were found in the rate of sperm abnormality among the 3 groups after varicocelectomy (P > 0.05).


CONCLUSIONS
Different grading indexes influence the changes of seminal parameters after varicocelectomy. The regurgitant volume of PPV and the combination of the regurgitant volume and the maximum diameter of PPV are more reasonable and reliable as the grading indexes of VC. Different grades of VC respond differently to varicocelectomy. Whether VC I necessitates varicocelectomy needs to be further investigated.
Liang
Rong-Xi
RX
Fujian Provincial Institute of Ultrasonic Medicine/Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China.
Xue
En-Sheng
ES
Lin
Li-Wu
LW
Chen
Shun
S
He
Yi-Mi
YM
Gao
Shang-Da
SD
Lin
Xiao-Dong
XD
D000328:Adult; D006801:Humans; D008297:Male; D012661:Semen / Q000166:cytology / Q000502:physiology*; D013076:Sperm Count; D013081:Sperm Motility; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014646:Varicocele / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery