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Andrologia ; 50(2)2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28766734

RESUMO

The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre. Thirty patients, 20-45 years old, were evaluated. Baseline pressure for maximum dilated ISV (A), less dilated ISV (B) and ESV was 15.93 ± 6.34, 12.38 ± 4.60 and 12.92 ± 5.65 mm. Hg, respectively, which increased after Valsalva by 104.4%, 116.2% and 38.22% respectively. Correlation (r = -.71; p < .05) was appreciated between percentage increase in pressure of ISV B with PSV of intraparenchymal testicular arteries and progressive motility (r = -.759; p < .05), nonprogressive motility (r = -.738; p < .05) and morphology (r = -.653; p = .07) of spermatozoa. In conclusion, ISV develops higher pressure on Valsalva as compared to ESV and has correlation with semen quality and testicular blood flow.


Assuntos
Infertilidade Masculina/fisiopatologia , Sêmen/fisiologia , Testículo/irrigação sanguínea , Varicocele/fisiopatologia , Veias/fisiopatologia , Adulto , Velocidade do Fluxo Sanguíneo , Humanos , Infertilidade Masculina/prevenção & controle , Masculino , Microcirurgia/métodos , Análise do Sêmen , Espermatozoides/fisiologia , Testículo/diagnóstico por imagem , Testículo/fisiopatologia , Ultrassonografia Doppler em Cores , Manobra de Valsalva , Varicocele/diagnóstico por imagem , Varicocele/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veias/diagnóstico por imagem , Veias/cirurgia , Pressão Venosa , Adulto Jovem
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