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World J Radiol. Feb 28, 2017; 9(2): 34-45
Published online Feb 28, 2017. doi: 10.4329/wjr.v9.i2.34
Potential role of imaging in assessing harmful effects on spermatogenesis in adult testes with varicocele
Athina C Tsili, Olga N Xiropotamou, Anastasios Sylakos, Vasilios Maliakas, Nikolaos Sofikitis, Maria I Argyropoulou
Athina C Tsili, Olga N Xiropotamou, Vasilios Maliakas, Maria I Argyropoulou, Department of Clinical Radiology, University of Ioannina, Medical School, University Campus, 45110 Epirus, Greece
Anastasios Sylakos, Nikolaos Sofikitis, Department of Urology, University of Ioannina, Medical School, University Campus, 45110 Epirus, Greece
Author contributions: Tsili AC and Xiropotamou ON contributed equally to this work; Tsili AC, Sofiktis N and Argyropoulou MI designed the research; Xiropotamou ON, Sylakos A and Maliakas V performed the research and analyzed the data; Tsili AC and Xiropotamou ON wrote the paper; all authors approved the final version of the article to be published.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Athina C Tsili, MD, Assistant Professor, Department of Clinical Radiology, University of Ioannina, Medical School, University Campus, Ioannina, 45110 Epirus, Greece. a_tsili@yahoo.gr
Telephone: +30-69-76510904 Fax: +30-26-51007862
Received: August 10, 2016
Peer-review started: August 11, 2016
First decision: September 12, 2016
Revised: November 2, 2016
Accepted: December 16, 2016
Article in press: December 19, 2016
Published online: February 28, 2017
Processing time: 201 Days and 16.5 Hours
Abstract

Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging (MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.

Keywords: Varicocele; Spermatogenesis; Diagnostic imaging; Ultrasonography; Doppler ultrasound imaging; Magnetic resonance imaging; Functional

Core tip: Varicocele is known as one of the main causes of male infertility. However, many controversies exist regarding the effect of varicocele on male reproductive potential, which patients to treat and whether repair leads to an improvement of the fertility status. Non-invasive imaging modalities, including functional sonography and magnetic resonance imaging, might provide useful information on the early damage of testicular structure by varicoceles, therefore helping clinicians target repair efforts to those men who will benefit from varicocele treatment.