{"id":2460,"date":"2009-11-25T11:47:28","date_gmt":"2009-11-25T11:47:28","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/urovar\/"},"modified":"2025-05-14T19:08:56","modified_gmt":"2025-05-14T19:08:56","slug":"urovar","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/urovar\/","title":{"rendered":"Color Doppler Ultrasound Diagnosis of Varicocele"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>In accordance with Sarteschi, varicocele can be divided into five grades according to the characteristics of the reflux and its length, and to changes during Valsalva\u2019s manoeuvre.<br \/>\n<!--more--><br \/>\nColor Doppler Ultrasound (CDU) classification of varicocele<\/p>\n<ul>\n<li>Grade 1 is characterised by the detection of a prolonged reflux in vessels in the inguinal channel only during Valsalva\u2019s manoeuvre, while scrotal varicosity is not evident in the previous grey-scale study.<\/li>\n<li>Grade 2 is characterised by a small posterior varicosity that reaches the superior pole of the testis and whose diameter increases after Valsalva\u2019s manoeuvre. The CDU evaluation clearly demonstrates the presence of a venous reflux in the supratesticular region only during Valsalva\u2019s manoeuvre.<\/li>\n<li>Grade 3 is characterised by vessels that appear enlarged to the inferior pole of the testis when the patient is evaluated in a standing position, while no ectasia is detected if the examination is performed in a supine position. CDU demonstrates a clear reflux only under Valsalva\u2019s manoeuvre.<\/li>\n<li>Grade 4 is diagnosed if vessels appear enlarged, even if the patient is studied in a supine position; dilatation increases in an upright position and during Valsalva\u2019s manoeuvre. Enhancement of the venous reflux after Valsalva\u2019s manoeuvre is the criteria that allows the distinction between this grade from the previous and the next one. Hypotrophy of the testis is common at this stage.<\/li>\n<li>Grade 5 is characterised by an evident venous ectasia even in an upright position. CDU demonstrates the presence of an important basal venous reflux that does not increase after Valsalva\u2019s manoeuvre.<\/li>\n<\/ul>\n<p>Scoring System for Color Doppler Ultrasound (CDU) Diagnosis of Varicocele<\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><\/td>\n<td align=\"center\">Score<\/td>\n<\/tr>\n<tr>\n<td><strong>Maximum vein diameter (mm)<\/strong><br \/>\n&lt;2.5 0<br \/>\n2.5-2.9<br \/>\n3.0-3.9<br \/>\n&gt;\/= 4.0<\/td>\n<td align=\"center\">0<br \/>\n1<br \/>\n2<br \/>\n3<\/td>\n<\/tr>\n<tr>\n<td><strong>Plexus\/sum of diameter of veins<\/strong><br \/>\nNo plexus identified<br \/>\nPlexus (+) with sum diameter &lt;3 mm<br \/>\nPlexus [+) with sum diameter 3-5.9 mm<br \/>\nPlexus (+) with sum diameter &gt;\/=6 mm<\/td>\n<td align=\"center\">0<br \/>\n1<br \/>\n2<br \/>\n3<\/td>\n<\/tr>\n<tr>\n<td><strong>Change of flow velocity on Valsalva maneuver<\/strong><br \/>\n&lt;2 cm\/s or duration &lt;1 second<br \/>\n2-4.9<br \/>\n5-9.9<br \/>\n&gt;\/=10<\/td>\n<td align=\"center\">0<br \/>\n1<br \/>\n2<br \/>\n3<\/td>\n<\/tr>\n<tr>\n<td><strong>Total score <\/strong><\/td>\n<td align=\"center\">0-9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>A total score of 4 or more determines the presence of a varicocele by CDU.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References<\/strong><\/p>\n<ol>\n<li>Chiou RK, Anderson JC, Wobig RK, Rosinsky DE, Matamoros A Jr, Chen WS, Taylor RJ. Color Doppler ultrasound criteria to diagnose varicoceles: correlation of a new scoring system with physical examination. Urology. 1997 Dec;50(6):953-6. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9426729\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Liguori G, Trombetta C, Garaffa G, Bucci S, Gattuccio I, Salam\u00e8 L, Belgrano E. Color Doppler ultrasound investigation of varicocele. World J Urol. 2004 Nov;22(5):378-81.<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15322805\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: 25 Nov, 2009<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[298],"tags":[1359,123,13,1358,505,1357,1356,1355,1360],"class_list":["post-2460","post","type-post","status-publish","format-standard","hentry","category-urology","tag-color","tag-diagnosis","tag-diagnostico","tag-doppler","tag-ecografia","tag-ultrasonido","tag-ultrasound","tag-urology","tag-varicocele"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2460","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2460"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2460\/revisions"}],"predecessor-version":[{"id":9378,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2460\/revisions\/9378"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2460"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2460"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2460"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}