بررسی ارتباط میزان دیامتر و وجود رفلاکس با آزمایش اسپرم در بیماران مبتلا به واریکوسل در بیمارستان شهید هاشمی‌نژاد در سال 1382

    Background & Aim: Varicocele is the dilation of the pampiniform venous plexus of testis more than 2 mm and is one of the most common causes of sperm abnormalities in infertile men. The main diagnostic test for varicocele is ultrasonography that evaluates the vein diameter in B mode exam and venous reflux in color Doppler exam, but there is no single agreement on the importance of these two findings in different references. This research was performed to evaluate the effect of these two factors on sperm analysis test. Patients & Method: This descriptive analytical cross-sectional study aimed to evaluate the relation of diameter and reflux to sperm analysis in patients with varicocele. With the help of sonography, maximum diameter of pampiniform venous plexus, presence and duration of reflux during valsalva maneuver were measured in 62 patients with varicocele. Then the patients were referred to the laboratory unit for sperm analysis(S/A). Results: The mean age of the patients was calculated to be 25.6 years(SD=5.08). 85.5% of the cases had left side involvement and 14.5% showed bilateral involvement. Mean diameter of left venous plexus and its mean reflux time were 3.62 mm and 2.30 seconds, while mean diameter of right venous plexus and its mean reflux time were 2.93 mm and 1.06 seconds respectively. Reflux was absent in 20.96% of them. Regarding routine criteria such as motility, morphology, sperm count, and the like, 54.66% was presented with abnormal S/A, of which abnormal morphology had the highest frequency(41%). The analysis of data revealed a direct significant statistical relationship between the diameter of left venous plexus and its reflux time, which means the reflux time increased significantly with increasing diameter of vein(PV=0.00, r=0.378). A reverse statistically significant relationship was observed between left side vein diameter and sperm motility(PV=0.019, r=-0.297) and between left side reflux time and sperm motility(PV=0.009, r=-0.325), which means motility decreases with increasing diameter and reflux time. In addition, the results of t-test showed a statistical difference between left side vein diameter and its reflux time for both groups with motility 50(PV=0.35, PV=0.002), which indicates that both vein diameter and reflux time were apparently more for the group with motility<50 than the normal group, but left side diameter and its reflux time showed no relation to other parameters of S/A such as abnormal morphology and sperm count, and the same was found about right side diameter and its reflux time. Moreover, no relation was detected between presence or absence of reflux and S/A abnormalities, and bilateral or unilateral involvement bore no relationship to sperm count, motility and abnormal morphology. Conclusion: We noticed that the presence or absence of reflux is not a suitable factor to determine prognosis or sperm abnormalities.