title: Is there any additional benefit of venous diameter and retrograde flow volume as measured by ultrasonography to the diagnosis of suspected low-grade varicoceles?
abstract: OBJECTIVE
  To investigate the relation between the findings of physical examination and ultrasonography and to evaluate whether venous diameter (VD) and retrograde flow volume (RFV) have any additional benefit to the diagnosis of suspected low-grade varicoceles.
  
  
  METHODS
  Five hundred and fifty-two patients who applied to our outpatient clinic due to infertility were assessed by physical examination (PE) and B-mode and color Doppler ultrasonography (CDUS). The correlation of VD and RFV with clinical grade and with each other was investigated in cases diagnosed as unilateral left varicocele.
  
  
  RESULTS
  Unilateral left varicocele was detected in 184 (33.3%) of 552 patients: mean VD of the subjects was 3.17 +/- 1.02 mm and mean RFV in 160 patients with a reflux was 24.01 +/- 13.76 ml/min. There was a correlation of clinical grade both with VD and RFV (r = 0.669, p < 0.001 and r = 0.603, p < 0.001, respectively). Considering VD and RFV, there was a significant difference between grade (G)1-G2 and G2-G3 (p < 0.001, p < 0.001, respectively) except between subclinic-G1 varicocele groups (p = 0.626, p = 0.529, respectively). The best cut-off point predicting the palpable varicocele on physical examination was 3.1 mm (sensitivity 58.2%) for VD and 14.5 ml/min (sensitivity 83.8%) for RFV.
  
  
  CONCLUSIONS
  Measurement of RFV is more sensitive than that of VD in predicting palpable varicocele. However, neither of them seem to have any additional benefit to PE in clarifying the diagnosis of suspected low-grade varicoceles.
authors.affiliation: Urology Clinic, S.B. Ankara Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey. hasanbakirtas@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Bakirtas
authors.forename: Murat
authors.initials: M
authors.lastname: Cakan
authors.forename: Can
authors.initials: C
authors.lastname: Tuygun
authors.forename: Serra Ozbal
authors.initials: SO
authors.lastname: Soylu
authors.forename: Hamit
authors.initials: H
authors.lastname: Ersoy
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D010808:Physical Examination; D012039:Regional Blood Flow; D014463:Ultrasonography; D014646:Varicocele / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014680:Veins / Q000000981:diagnostic imaging / Q000473:pathology