Comparison of scrotal thermography and scrotogram in the diagnosis of varicoceles / 대한비뇨기과학회지

Varicocele is the most frequent cause of male subfertility. Because it is the most common surgically correctable cause of male infertility, its diagnosis is important. For diagnosis of varicoceles, venography, thermography, and doppler stethoscope were available, but they involved invasiveness, inaccuracy, lack of objectivity and cosiliness. Two noninvasive methods for detecting varicoceles. scrotogram using Technetium and digital infrared thermography imaging(DITI), were evaluated in 52 patients complaining of infertility. The results of scrotogram and thermography were not consistent in these patients. When the varicoceles were confirmed with internal spermatic venography or high ligation of internal spermatic vein, the physical examination was the most accurate method. compared with scrotogram and thermography. Scrotogram (0.73) was more sensitive than thermography(0.64). The each combination of the two of physical examination scrotogram and thermography increased the accuracy in terms of sensitivity and positive predictive value. This study suggest that the combination of scrotogram and thermography with physical examination would increase the diagnostic accuracy in the varicoceles.

Clinical Application of 'Scrotogram' / 대한비뇨기과학회지

A study was undertaken during the past 2 years of patients who visited the infertility clinic of this hospital. The patients included those with male infertility, scrotal mass, scrotal pain or impotence. These patients were studied by means of reviewing the clinical applications of 'Scrotogram' and the following results were obtained. A total of 122 cases underwent a 'Scrotogram' study and among them 80 cases were diagnosed as varicocele, which included 14 cases( 18%) of subclinical varicocele which are difficult to be diagnosed by initial physical examination. There was statistical significance in the varicocele index between the control group and the Grade I varicocele group(p<0.01) and between the control group and subclinical varicocele group(p<0.01), and between the Grade I and Grade II group.(p<0.01), and between the Grade II and Grade II group(p<0.05). Among 66 clinical varicocele patients, 63 cases(80% ) were diagnosed by varicocele index, and 54 cases(82% ) were diagnosed by static image. A combination of the above two methods allowed 61 cases(92%) to be diagnosed. Among 48 patients who underwent high ligation of internal spermatic vein, 25 patients were subject to postoperative follow-up 'Scrotogram', which revealed 12 cases with excellent results, 8 cases with good results, and 5 cases with poor results. The average varicocele index before and after surgery was 1.78 and 1.24 and there were statistical significance(p<0.01). There was statistical significance, in sperm count and motility between the control group and clinical varicocele group(p <0.01) and between the control group and subclinical varicocele group(p <0.01). However, there appeared no statistical significance in semen character between the clinical varicocele and subclinical varicocele group. Among the 13 patients who were subject to postoperative follow-up semen analysis 11 patient showed improved results, and there was marked improvement in sperm count(p<0.05). There was slight improvement in sperm motility and morphology but showed no statistical significance. At present, 2 patients were impreged. Among 110 patients with infertility and olieoasthenoteratozoospermia, 22 were initially diagnose as varicocele by physical examination only, and 7 patients were diagnosed as subclinical varicocele after a 'Scrotogram' was taken. In conclusion, the 'Scrotogram' is able to identify varicocele objectively, and also identify subclinical varicocele which is an important contributing factor to male infertility. Also, this method of study is able to assess the postoperative result of varicocele accurately.

A Study about Reliability of Radioisotope in Diagnosing Varicocele / 대한비뇨기과학회지

In order to consider the usefulness of radioisotope in diagnosing varicocele, a study was performed on 124 cases. Among them, 74 cases were diagnosed as varicocele, which included 16 cases of subclinical varicocele. Among 74 varicocele patients, 62 cases ( 83.8%) were diagnosed by varicocele index and 59 cases (79.7% ) were diagnosed by static image. A combination of the above two methods allowed 67 cases (90.5 %) to be diagnosed. 21 patients who had a high ligation of internal spermatic vein showed 11 excellent results, 6 good results and 4 poor results. Out of 10 patients with subclinical varicocele, there were 6 excellent results, 3 good results and 1 poor result and 9 patients showed improvement on postoperative semen analysis. There was no significant statistical difference in frequency of the testicular arterial insufficiency between the small varicocele group and the large varicocele group. Also, through scrotogram, it became known that semen analysis proved little help in aiding the diagnose of subclinical varicocele. In conclusion, 'Scrotogram proved very helpful in diagnosis and judging the results of operations of varicocele including subclinical varicocele.