MP12-20 EFFICACY OF VALSALVA MANEUVER AND STANDING POSITION DURING SCROTAL DOPPLER ULTRASONOGRAPHY OF VARICOCELE PATIENTS

Abstract

You have accessJournal of UrologyImaging/Radiology III1 Apr 2014MP12-20 EFFICACY OF VALSALVA MANEUVER AND STANDING POSITION DURING SCROTAL DOPPLER ULTRASONOGRAPHY OF VARICOCELE PATIENTS Soon Ki Kim, Yoo Seok Kim, Sung bin Kim, In-Chang Cho, and Seung Ki Min Soon Ki KimSoon Ki Kim More articles by this author , Yoo Seok KimYoo Seok Kim More articles by this author , Sung bin KimSung bin Kim More articles by this author , In-Chang ChoIn-Chang Cho More articles by this author , and Seung Ki MinSeung Ki Min More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.455AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ultrasonography is the most practical and most accurate noninvasive technique, but does not always show reflux into the spermatic veins or pampiniform plexus in resting and supine position. We investigated effectiveness of Valsalva maneuver and standing position on color Doppler ultrasound for the varicocele diagnosis and devised a new index that can improve existing diagnostic criteria. METHODS A total of 54 men (36 with clinical varicocele and 18 without clinical varicocele) who visited this hospital from January 1, 2011 until April 31, 2013 were investigated by physical examination and color Doppler ultrasound. The mean age of patient group was 21.4 years and that of control group was 21.5 years. Diameters of the largest vein in the pampiniform plexus were measured bilaterally during resting and Valsalva maneuver in the supine position followed by same examination with the subjects standing. We calculated the ratio of mean of maximal vein diameter (mMVD) during resting and Valsalva maneuver (resting-Valsalva ratio) and compared in the both position. RESULTS In patient group, 4 patients were at grade I (11%), 15 patients grade II (42%), and 17 patients grade III (47%) on physical examination. In the resting and supine position, mMVDs were 1.8mm, 2.0mm, 2.5mm (grade I, II, III, respectively) and 1.3mm (control group). Compared with control group, only grade III varicoceles showed a significant difference (P<0.05). During Valsalva maneuver in the supine position, mMVDs were 3.0mm, 3.4mm, 4.2mm (grade I, II, III, respectively) and 1.8mm (control group), and in all cases P-value was below 0.05. Average of resting-Valsalva ratio in the supine position were 0.69, 0.74, 0.74 (grade I, II, III, respectively) and 0.44 (control group), and there were no significant difference between patient and control group (p>0.05). Whereas in the resting and standing position, mMVD were 2.8mm, 3.3mm, 3.8mm (grade I, II, III, respectively) and 1.8mm (control group) (p<0.05). During Valsalva maneuver in the standing position, mMVD were 5.0mm, 5.8mm, 6.6mm (grade I, II, III, respectively) and 2.5mm (control group). And average resting-Valsalva ratio were 0.76, 0.90, 0.71 (grade I, II, III, respectively) and 0.26 (control group), which showed significant difference from all grades (p<0.05). CONCLUSIONS It is suggested that the standing position and Valsalva maneuver during scrotal Doppler ultrasonography could improve diagnostic ability for varicocele. Resting-Valsalva ratio could be a new diagnostic index for varicocele diagnosis using scrotal Doppler sonography. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e113 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Soon Ki Kim More articles by this author Yoo Seok Kim More articles by this author Sung bin Kim More articles by this author In-Chang Cho More articles by this author Seung Ki Min More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...