Intratesticular varicocele: Evaluation using conventional and Doppler sonography

OBJECTIVE. The aim of this study was to describe the conventional and Doppl er sonographic appearances of intratesticular varicoceles and to determine their occurrence. SUBJECTS AND METHODS. One thousand forty men with various testicular proble ms were examined using conventional and Doppler sonography, and the inciden ce of intratesticular varicocele and other conditions was recorded. Eightee n patients with intratesticular varicoceles were further examined, allowing us to study the various sonographic and Doppler parameters of this rare en tity. RESULTS Intratesticular varicocele was identified in 18 (1.7%) patients. Th e condition was bilateral in seven patients and unilateral in 11. Of 25 tes tes involved, 12 (48%) were right-sided and 14 (56%) were isolated without any ipsilateral extratesticular varicocele. The shape of the intratesticula r varicocele was tubular in 21 cases and oval in five; one patient had both oval and tubular varicoceles. Diameters ranged from 2 to 8 mm (mean, 3.1 m m). Mean venous flow velocity was 2.8 cm/sec and had an inverse relationshi p to the diameter of the intratesticular varicocele. CONCLUSION. Intratesticular varicocele is seen in fewer than 2% of the symp tomatic population. The condition has a characteristic sonographic appearan ce of dilated tubular intratesticular veins with a proximity to the mediast inum testis. Variations from previously published reports included presenta tion with an oval shape, more frequent bilateral occurrence, greater number of isolated right-sided intratesticular varicoceles, and fewer association s with an extratesticular varicocele.