Color Doppler ultrasound characteristics after subinguinal microscopic varicocelectomy.
OBJECTIVE
The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters.


METHODS
Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome.


RESULTS
A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively).


CONCLUSIONS
The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.
Selcuk University, School of Medicine, Department of Urology, Konya,Turkey. drmuratakand@yahoo.com.
Murat
M
Akand
Selcuk University, School of Medicine, Department of Radiology, Konya, Turkey.
Mustafa
M
Koplay
Selcuk University, School of Medicine, Department of Radiology, Konya, Turkey.
Necat
N
Islamoglu
Selcuk University, School of Medicine, Department of Urology, Konya,Turkey.
Emre
E
Altintas
Selcuk University, School of Medicine, Department of Urology, Konya,Turkey.
Ozcan
O
Kilic
Selcuk University, School of Medicine, Department of Urology, Konya,Turkey.
Murat
M
Gul
Bilim University, Sisli Florence Nightingale Hospital, Department of Urology, Istanbul, Turkey.
Haluk
H
Kulaksizoglu
Selcuk University, School of Medicine, Department of Radiology, Konya, Turkey.
Mesut
M
Sivri
Selcuk University, School of Medicine, Department of Urology, Konya, Turkey.
Serdar
S
Goktas
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D013085:Spermatic Cord / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013737:Testis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018615:Ultrasonography, Doppler, Color; D014646:Varicocele / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult