Introduction: Varicocele is an enlargement of the scrotum veins (>2mm). About one in six men have varicocele. Varicocele can be related to low sperm production and decreased sperm quality, although not always it occurs. Subject: try to establish a correlation between intratesticular vascular acceleration and poor spermatogenesis.
Method: We examined 33 consecutive men with infertility. All patients underwent scrotal US, Color Doppler spectral analysis of the testicles and sperm study.
Results: Testicles volume varied from 7,9 to 19,9 cc (mean 14,0 cc) on the right and from 2,3 to 20,1 cc on the left (mean 12,8 cc). The mean diameter of pampiniforme vein was 21,8 mm on the right and 33,2 mm on the left. Seven (21%) patients had no varicocele and 26 patients (79%) had varicocele. Six of the 26 patients with varicocele (18,1%) had normal sperm study and 20 patients (60%) with varicocele had abnormal sperm. Among the 20 patients who had varicocele and abnormal sperm, 19 (95%) had a decrease in acceleration (9,2 cm/s2 to 80,0 cm/s2; mean 60,0 cm/s2).
Discussion: The varicocele pathophysiologic mechanisms that cause decreased spermatogenesis is related to scrotum higher temperatures and small volume. Varicocele increases hydrostatic pressure with venous stasis, high local temperature and fibrosis. The spectral intratesticular waveform had a low-resistance pattern (Mean RI 0.52). Our study had a decreased testicular acceleration flow (tardus parvus) in almost all patients with varicocele and affected spermatogenesis.
Conclusion: varicocele can be associated with intratesticular vascular decrease acceleration in patients with affected spermatogenesis.