The Correlation of the Degree of Varicocele with Duplex Doppler Ultrasonographic Diameter of the Pampiniform Plexus and the Retrograde Venous Flow / 대한비뇨기과학회지

PURPOSE: Retrograde flow is the main criterion for the diagnosis of varicocele, and the Duplex Doppler ultrasonographic values for retrograde flows are poorly defined. The purpose of this study is to assess a relationship between the palpated varicocele and pampiniform plexus diameter and the retrograde flow that was investigated with performing Duplex Doppler ultrasonography (DDU). MATERIALS AND METHODS: Physical examinations and DDU were performed to assess varicoceles in forty patients with left-sided varicocele and also in eight men who were without varicocele on their physical examination. During both normal respiration and the Valsalva's maneuver, the maximum diameters of the pampiniform plexus and the presence of the retrograde flow were measured by DDU. RESULTS: The highest mean venous diameter in the patients with clinical grade III varicocele was 2.7mm (2.4-3.6), and this was significantly higher than that in the patients with grade I (1.9mm) or with grade II varicocele (2.1mm) (p<0.05). While the difference of diameters between grade I and grade II was not significant, venous reflux was found in all degrees of the varicocele veins. Venous reflux during the Valsalva maneuver (type II flow pattern) was detected on the right side in one (8%) of 13 patients with grade II varicocele, and in three (21%) of 14 patients with grade III varicocele. The type III flow patterns, indicating augmenting of the reflux with an intra-abdominal pressure increase, were 46.1%, 69.2% and 100% for grade I, II and III, respectively. No venous reflux was found in the control group. CONCLUSIONS: The presence of retrograde flow may provide a more reliable indicator than does the spermatic vein diameter for the diagnosis of varicocele. When the palpability of the pampiniform plexus is questionable, Duplex Doppler ultrasound is indicated.

Leiomyoma of the Epididymis / 대한비뇨기과학회지

A rare case of an epididymal leiomyoma in a 62-year-old man is reported. A physical examination revealed a hard, non-tender, 2cm sized round mass located in the tail of the right epididymis. Scrotal ultrasonography showed a 2.1x2cm sized, well defined round inhomogeneous mass within the tail of the right epididymis. A right epididymectomy was performed. The diagnosis was confirmed by surgical excision and subsequent histological analysis.

Cystic Dysplasia of the Testis Associated with Ipsilateral Hypoplastic Type of Renal Dysplasia and Ureterovesical Junction Obstruction / 대한비뇨기과학회지

Cystic dysplasia of the testis is a rare benign congenital lesion of the rete testis that is often associated with renal and ureteral abnormalities. Herein, a case of cystic dysplasia of the testis, associated with an ipsilateral hypoplastic type of renal dysplasia and an ureterovesical junction obstruction, is reported in a 7-year-old boy.