By A. N. Dardenne, P. Bodart, P. J. Van Cangh (auth.), Claude C. Schulman M. D. (eds.)
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Extra resources for Advances in Diagnostic Urology
The presence of an incompetent valvular mechanism was assumed in the cremasteric system when contrast medium flowed freely into the scrotum. Varicoceles were classified into four groups as a result of these investigations (Table 1). Where internal spermatic reflux was demonstrated to a significant degree on left renal venography, confirmed on peroperative ascending venography and in the absence of any cremasteric reflux, a pure internal spermatic varicocele was assumed: Ten such cases were Qoted in aseries of 25 patients.
Five men in a post-operative group of 22 patients were found to have a persistence of spontaneous venous activity. Four had only intermittent venous reflux and only the patient with clinical evidence of a persistent varicocele was found to have continuous venous reflux. Perrin et aI. (1980) in their studies with the Doppler technique also found it to be useful in the post-operative assessment of patients. In a group of 20 patients whom they studied before and after operation with the Doppler technique, they found that 11 patients with doubtful clinical varicoceles, with a positive Doppler examination, were cured by the operation both clinically and by Doppler examination.
38 J. P. Pryor Pattern 6 - This pattern was only recognised over the inguinal canal in patients with a varicocele and it is thought to represent a forward flow ofblood during quiet respiration which ceased during the Valsalva manoeuvre. It is thought this pattern might represent the flow ofblood in the cremasteric veins. The incidence of these wave-form patterns in patients with and without a varicocele is shown in Table 2. This shows that in the 45 patients with a left-sided varicocele, wave forms 3, 4 or 5 were seen in 89% of the spermatic cords where there was clinical evidence of a varicocele.