Histologic evaluation of spermatic veins in patients with varicocele

Background: Information concerning varicocele is limited in spite of its cl inical importance. This study intends to clarify anatomical features of var icocele. Methods: Spermatic veins were obtained from varicocele patients at surgery. Areas of two distinct portions (extracellular matrix and smooth muscle) we re measured by a micro computer imaging device image analysis system on his tologic slides with Masson trichrome stain. In addition, we evaluated the s hape and arrangement of the smooth muscle fibers by a scanning electron mic roscope (SEM). Results: Masson trichrome stain revealed that grade of varicocele partly co rrelated with thickness of the wall and with amount of the smooth muscle fi bers. In the patients with grade 3 varicocele, SEM examination showed marke d hypertrophy of longitudinal smooth muscle fibers, which were discriminate d clearly from the inner circular fibers. Conclusions: This study indicated that morphological changes occurred in th e muscle layers of varicoceles in the worst grade of varicocele. These stru ctural changes which result from abnormal venous blood circulation may caus e development of varicocele, resulting in male infertility.