The Investigation of the Relationship Between Semen Analysis and Doppler Ultrasonografic Findings of Reflux Flow in Patients with Subclinical Varicocele

Objective: The aim of the present study was to the measurement of reflux flow volume, velocity and duration withcolor doppler ultrasonography (CDUS) in subclinical varicocele cases, and comparison of CDUS findings with semenanalysis.Method: 219 infertile men with no clinical overt varicocele are examined with CDUS. 61 people who have veindiameter bigger than 2 mm, or have 1 second or longer reflux flow were classified as subclinical varicocele. CDUSexamination is implemented in decubitus position. Reflux flow volume, velocity and duration of reflux in plexuspampiniformis veins were measured bilaterally during Valsalva maneuver.Results: In subclinical varicocele cases, mean vein diameters were measured mean 2.35 mm while resting, and 2.61mm during Valsalva maneuver. With Valsalva mean reflux flow volume was 13.56 mL/min, duration was 1.32 sec,flow velocity was 5.6 cm/sec. There were anomaly in semen analysis of 13 of these cases (21.3%). A significantcorrelation between reflux duration and reflux flow velocity are found. However, no significant relation betweenreflux flow volume, velocity and duration with semen analysis is detected.Conclusion: In subclinic varicocele cases, CDUS is a valuable diagonistic procedure that is quite successful on detectingthe vein diameter and reflux. No relation was found between reflux flow volume, velocity and duration with semenanalysis. However, a study commited with a larger group could give more useful information.

Subklinik Varikosel Olgularında Semen Analizi ile Reflü Akımın Doppler Ultrason Bulguları Arasındaki İlişkinin Araştırılması

Amaç: Fizik muayene ile tespit edilemeyen subklinik varikosel olgularında renkli Doppler ultrasonografi (RDUS) ile reflü debisi, akım hızları ve akım sürelerinin ölçümü, RDUS bulgularının semen analizi ile ilişkisini araştırmak. Yöntemler: İnfertilite bakımından araştırılan ve klinik olarak varikoseli olmayan toplam 219 olguya renkli Doppler US incelemesi yapıldı. Ven çapları 2 mm’den büyük veya 1 sn ve daha uzun süreli reflü akımı bulunan 61 kişi subklinik varikosel kabul edilerek incelemeye dahil edildi. Bu olgularda RDUS incelemesi sırtüstü yatar pozisyonda uygulandı. Her iki tarafta pleksus pampiniformis venlerinde istirahatte ve Valsalva manevrası esnasında reflü debisi, akım hızı, akım süresi ölçüldü. Subklinik varikosel olgularında semen analizindeki anormallik ile RDUS incelemelerinde tespit edilen reflü debisi, akım hızı ve akım süreleri arasında ilişki varlığı araştırıldı. Bulgular: Subklinik varikosel olgularında ven çapları istirahat halinde ortalama 2.35 mm, valsalva ile 2.61 mm ölçüldü. Valsalva ile ortalama reflü debisi 13.56 mL/dk, akım süreleri 1.32 sn, akım hızları 5.6 cm/sn bulundu. Bu olguların 13 ünde semen analizinde anormallik mevcut idi (%21,3). Reflü süresi ile reflü akım hızları arasında anlamlı korelasyon bulunmuştur. Ancak reflü debisi, hızları ve süresi ile semen analizleri arasında belirgin bir ilişki tespit edilemedi. Sonuç: Subklinik varikosel olgularının tespit edilebilmesi için RDUS değerli bir tanı yöntemi olup ven çapı ve reflünün tespitinde oldukça başarıldır. Reflü debisi, akım hızı ve reflü süresi ile semen analizi arasında anlamlı ilişki bulunamamıştır. Ancak daha büyük bir grupla yapılacak çalışma daha faydalı bilgiler verebilir.

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