The evaluation of saphenofemoral insufficiency in primary adult varicocele

Abstract

PurposeThe aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele.Patients and methodsA total of 40 patients with the primary diagnosis of varicocele were included in the study. A total of 40 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by means of palpation and observation of each spermatic cord in standing position before and during a Valsalva maneuver. In addition, scrotal Doppler and lower extremity venous Doppler ultrasonography (US) were performed. Patients who had spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler US, a retrograde flow lasting longer than 0.5 s during normal breathing or at the Valsalva maneuver was considered to be indicative of saphenofemoral junction (SFJ) insufficiency.ResultsTwenty-five (62.5%) patients had SFJ insufficiency in the study group, whereas 11 patients (27.5%) had insufficiency in the control group. Of the 40 study participants, 10 participants had recurrent varicocele. All of them were seen to have SFJ reflux on Doppler US (100%) (P = 0.014). The patients with primary varicocele had a statistically significantly (P = 0.02) higher rate of venous insufficiency in their SFJs when compared with the control group.ConclusionThe results of the present study show that the incidence of SFJ reflux increases in individuals with varicocele, with a higher incidence in cases of recurrent varicocele. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from SFJ insufficiency.