ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.

H. M. Gad and A.H. Ahmed.

Radiology Dept., Nephrology and Urology Center and Dermatology, Venereology & Andrology Department, Mansoura University, Mansoura, Egypt.

The detection of a varicocele represent an important part of the infertility workup because these dilated veins may contribute to the infertility problem, and the problem may be correctable.

The aim of this work was to evaluate scrotal scintigraphy as a screening measure of varicocele and to study testicular vascular disturbances that may be associated with this illness. This study was conducted on a total of fifty infertile patients with varicocele and eleven normal controls. Patients were grouped into four groups according to clinical classification. All patients and controls were subjected to thorough history and full examination.

Using color duplex Doppler sonography, diameters of the pampiniform plexus of veins, testicular arterial diameters and blood velocities were measured in relation to testicular size. Then, scrotal scintigraphy was performed by injection of 20 mCi of 99mTc Pertechnetate I.V. to detect testicular perfusion and radioactive uptake. We have detected 89.5% sensitivity and 90.9% specificity of scintigraphy compared to color duplex Doppler ultrasonography Significant decreases in arterial blood velocity and testicular perfusion were detected specially with large varicoceles which showed also, significant decrease in testicular arterial diameters compared to control. These changes could be correlated to decrease of testicular size.

In conclusion, scintigraphy is a simple non invasive, with potential exposure, screening test of varicocele. There are decreases in testicular arterial perfusion, arterial blood velocity and to some extent arterial diameter. These changes may be correlated to testicular growth retardation in this possibly correctable cause of male infertility.