THE INCIDENCE OF VARICOCELES IN THE GENERAL-POPULATION WHEN EVALUATEDBY PHYSICAL-EXAMINATION, GRAY-SCALE SONOGRAPHY AND COLOR DOPPLER SONOGRAPHY

The association between male subfertility and varicocele has long been recognized. Physical examination is the most widely used method for d etecting varicoceles but other techniques may be more sensitive. Color Doppler sonography has the theoretical advantage of allowing direct d emonstration of reversed flow in the testicular veins. The frequency o f detection of reversed flow by color Doppler ultrasound in a normal p opulation is, however, unknown. We evaluated 34 asymptomatic young men with physical examination, standard scrotal sonography and color Dopp ler evaluation of the scrotal veins. Findings were correlated with sem en analysis. Of the subjects 15% had varicoceles by physical examinati on and 18% by scrotal sonography, while 35% had retrograde flow by col or Doppler evaluation. The majority of men in this population did not exhibit retrograde flow within the gonadal veins when evaluated by col or Doppler sonography. The physiological significance of retrograde fl ow, however, remains to be defined.