Journal of Andrology
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Published-Ahead-of-Print March 4, 2010, DOI:10.2164/jandrol.109.009258

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The Evaluation of Sapheno-Femoral Insufficiency in Primary Adult Varicocele

Hakan Koyuncu *, Mehmet Ergenoglu , Faruk Yencilek , Nilay Gulcan , Neslihan Tasdelen , Esin Yencilek , and Kemal Sarica

* To whom correspondence should be addressed. E-mail: hakan.koyuncu{at}yeditepe.edu.tr.

Purpose: The aim of this study was to evaluate the possible relationship between varicocele and sapheno-femoral insufficiency in patients diagnosed with primary varicocele problem. Patients and Methods: A total of 70 patients with the primary diagnosis of varicocele were included into the study. A total of 30 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by palpation and observation of each spermatic cord in standing position before and during a valsalva maneuver. Additionally, scrotal Doppler and lower extremity venous Doppler ultrasonography were performed. Patients who were with spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler ultrasonography, a retrograde flow lasting longer than 0.5 seconds during normal breathing or at the valsalva maneuver was considered to be meaningful for sapheno-femoral junction insufficiency. Results: Thirtysix (51.35%) patients had insufficiency in sapheno-femoral junction in the study group [6 (8.5%) bilateral, 30 (42.85%) unilateral] whereas 8 (26.6%) had insufficiency in the control group [2 (6.6%) bilateral, 6 (20%) unilateral insufficiency]. The patients with primary varicocele had a statistical significant (p=0.02) higher rate of venous insufficiency in their sapheno-femoral junctions when compared with the control group. Conclusions: In the present study, the rate of sapheno-femoral insufficiency has been found to be statistically higher in patients with primary varicocele compared to healthy men. Depending on the common presence of valvular insufficiency; we believe that the presence of varicocele should be investigated in the young population suffering from sapheno-femoral junction insufficiency.


Key words: Varicocele • saphenofemoral • varicose veins • venous insufficiency






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