The Effectiveness of Color Doppler Ultrasonography in The Evaluations of The Success After Varicocelectomy

Objective: The effect of high ligation varicocelectomy in the color Doppler ultrasonography and spermiogram parameters in the clinically and radiologically diagnosed oligoasthenospeimic varicocele patients.
Patients and Methods: Clinically and radiologically diagnosed 34 adult patients (mean age 27) with oligoasthenospermia were included in the study. Total 54 varicocele units were operated and twenty of them were bilateral. The diagnosis of varicocele was made by clinical examination and with color doppler ultrasonography in all cases. Subclinic varicocele was found in 18(33%) cases. 26 of cases were classified as G2-3 varicoceles and 10 cases as G1 varicoceles. High ligation varicocelectomy was performed in all cases. All of the radiologic exams were made in the same department. Follow up was made after 6 months by examine of spermiogram and color doppler ultrasonography.
Results: The signs of reflux in the color Doppler ultrasonography were found postoperatively in twelve units out of 54 operated. In 18 subclinic varicocele units reflux were not found postoperatively. Spermogram parameters were not improved in patients whom Doppler ultrasonography findings were continued in postoperative period. In 12 out of 20 bilateral and 8 out of 14 unilateral varicocele patients (20 units out of 34 units, %59) spermiogram parameters were improved. In 6 (15%) out of 40 bilateral cases reflux was continued and in 34 cases was stopped. In 12 (60%) of these patients spermiogram parameters were improved. In 8 of them spermiogram parameters were not changed or worsened. In 6 (43%) out of 14 bilateral varicocele patients reflux was continued and in 8 (57%) of them was stopped. In 6 (43%) out of this group spermiogram parameters were similar or worsened in 8 patients spermiogram parameters were improved.

Varikoselektomi Giriþiminin Baþarýsýný Belirlemede Renkli Doppler Ultrasonografýnin Kullanýlabilirliði

Amaç: Klinik bulgular ve renkli doppler ultrasonografý ile varikosel tanýsý konmuþ oligoastenospermili olgularda yüksek ligasyoýý varikoselektomiýýin, renkli doppler ultrasonografý ve spermiogram parametreleri üzerindeki etkisini araþtýrmak.
Hastalar ve Yöntem: Yaþ ortalamasý 27 olan, klinik ve renkli doppler ultrasonografý ile varikosel tanýsý almýþ oligoastenospermili 34 yetiþkindeki, 20‘si bilateral 54 olgu prospektif çalýþma kapsamýna alýndý. Varikosel tanýsý klinik bulgulara ek olarak tüm olgularda renkli doppler ultrasonografý bulgulan ile kondu. 1S(%33) olguda sýýbklinik varikosel belirlendi. Olgularýn tümüne yüksek ligasyoýý varikoselektomi operasyonu uygulandý. Renkli doppler ultrasonografý ayný radyoloji merkezinde gerçekleþtirildi. Operasyondan 6 ay sonra renkli doppler ultrasonografý ve spermiogram ile olgular yeniden deðerlendirildi.
Bulgular: Çalýþmada yer alan 54 olgunun 12‘sinde (%22) renkli doppler ultrasonografide bulgulannýn sürdüðü gözlendi. 18 subklinik varikosel olgusunun tümünde renkli doppler ultrasonografi bulgulan ortadan kalktý. Doppler ultrasonografý bulgulannýn sürdüðü olgularýn hiçbirinde sperm parametreleri düzelmedi. Bilateral varikoseli olan 14 hastanýn 8‘itýde olmak üzere toplam 34 hastanýn 20‘sinde (%59) spermiogram parametrelerinde düzelme bildirildi. Bilateral varikoselektomi operasyonu uygulanan 40 olgunun 6‘sýnda (%15) postoperatif olarak reflünütý devam ettiði, 34‘ünde(%85) ortadan kalktýðý gözlendi. Bu olgularýn 12‘sinde (%60) spermiogram parametrelerinin düzeldiði S‘itýde (%40) ise deðiþmediði veya kötüleþtiði saptandý. Tek taraflý varikoselektomi operasyonu uygulanan 14 olgunun 6‘sýnda (%43) reflünütý sürdüðü, S‘itýde (%57) ortadan kalktýðý gözlendi. Bu gruptaki olgularýn 6‘sýnda (%43) spermiogram parametreleri ayný kaldý ya da kötüleþti, 8 olguda (%57) ise spermiogram parametrelerinde düzelme gözlendi.