Study On The Application Of Ultrasonography In Male Infertility With Varicocele

Objectives To investigate the objective indexes of the diagnosis in male infertility with varicocele by ultrasonography. To observe bilateral testis volume and echo intensity of infertile men with unilateral Varicocele. To provide the objective indexes for the reason of male infertility caused by varicocele. Methods 35 healthy male volunteers whose physical examinations and semen analyses were normal and 130 infertile men with left varicocele were detected by ultrasonography using a 7.5~10.0MHz linear-array transducer. The maximal internal spermatic vein diameter at rest and Valsalva maneuver, maximal velocity and duration of reflux in veins at rest and following Valsalva maneuver were detected. The testis volume of both side were also measured. The testis echo intensity was evaluated by ultrasound histogram first time. Varicocele size was graded with SVC, VCⅠ, VCⅡ and VCⅢ according to physical examination and ultrasonography. The maximal internal spermatic vein diameter,maximal velocity and duration of reflux in spermatic vein, testis volume and echo intensity of testis were compared between the study and control groups respectively. The maximal internal spermatic vein diameter at rest was made correlation analysis with other parameters. 　　Results　 (1)The differences in maximal internal spermatic vein diameter, maximal velocity and duration of reflux in spermatic vein, testis volume and echo intensity of testis between the right and left sides were not statistically significant in the control group (P>0.05). But the differences in left maximal internal spermatic vein diameter, maximal velocity and duration of reflux in spermatic vein between the study and control groups were statistically significant (P<0.01), and the differences between VC groups were also statistically significant in the study group (P<0.01). (2) The testis volume of both sides in the study groups was significantly smaller than that of control group (P<0.01), and left testis volume was also smaller than right among VC groups (P<0.01). The left testis volume in the VCⅢ group was significantly smaller than that of SVC group (P<0.05), and the right testis volume in the VCⅢ group was also significantly smaller than that of control group (P<0.05). The difference in left testicular atrophy rate between VC groups was statistically significant in the study group (P<0.01). (3)The echo intensity of left testis in VCⅡand VCⅢ groups was statistically lower than that of control group (P<0.05), but the difference in echo intensity of left testis between SVC, VCⅠ and control groups was not statistically significant (P>0.05). The echo intensity of right testis in VCⅢ group was statistically lower than that of control group (P<0.05). (4)The maximal internal spermatic veindiameter at rest was positively correlated with maximal velocity and duration of reflux in spermatic vein at Valsalva maneuver, Atrophy index and negatively correlated with testis volume of both sides, but it has no correlation with the testis echo intensity of both sides.　 Conclusions ⑴Unilateral varicocele can cause bilateral testis volume and echo intensity decrease. Both unilateral subclinical varicocele and clinical varicocele can cause testicular atrophy. The bigger VC size is, the higher testicular atrophy rate is.⑵Ultrasonography can provid the accurate internal spermatic vein diameter, hemodynamics, the testis volume and echo intensity to male infertility caused by varicocele, it also can screen the reason of male infertility. ⑶Ultrasound histogram is a utility method to assess the echo intensity of testis with varicocele, it can evaluate the testis function of varicocele patients combined with testis volume and semen analyses.