Hemodynamic evaluation of left testicular varicocele by scrotal scintigraphy

Objective: Scintigraphically assessed hemodynamics of left testicular varic oceles were correlated with spermatogenesis and the effect of varicocelecto my. Methods: Comparison of the time-activity curve (TAC) of the left hemiscrotu m with those of the femoral artery and femoral muscle identified three type s of scrotal TAC:TAC-1 peaked as rapidly as in the femoral artery; TAC-3, a s slowly as in femoral muscle, and TAC-2, intermediate between these. Compa rison of TAC of the left hemiscrotum before and after varicocelectomy was d one. Testicular biopsy specimens and the effect of varicocelectomy on semen analyses were compared between the types of TAC. Results: 60 patients were divided into 3 groups: 17 in TAC-1; 13 in TAC-2, and 30 in TAC-3. The TAC of the left scrotum showed the same TAC pattern as the left femoral muscle in each patient after varicocelectomy. Spermatogen esis deteriorated most in biopsy specimens from TAC-2 pa tients. Semen anal ysis showed improved total motile sperm counts in 58.8, 69.2 and 26.7% of T AC-1, TAC-2, and TAC-3 patients, respectively. Conclusions: TAC-1 and TAC-2 patients were better candidates for varicocele ctomy than TAC-3 patients. The hemodynamics of the internal spermatic veins and pampiniform plexus in TAC-3 patients might be different from those in TAC-1 and TAC-2 patients. Copyright (C) 2001 S. Karger AG, Basel.