Aim: The aim of the study was an assessment of the effects of varicocele on testis parenchyma and microcirculation with the use of the dynamic tissue perfusion measurements. Methods: Color Doppler sonographic dynamic testis parenchyma perfusion measurements were performed with Pixel-Flux software in 30 children with left testis varicocele. The right testes without varicocele comprised the control group. Results: Testicular parenchymal perfusion in testes with varicocele was reduced when compared to the control testes. The differences were found in all measured perfusion parameters. Statistical significance was found in the case of mean velocity and resistance index parameters. According to the grade of varicocele, the perfusion was the most reduced in patients with grade III of varicocele. Conclusion: Testicular parenchymal perfusion decreases in patients with varicocele, mostly in higher grades of varicocele. In case of validation, the method can be used in determining the damage of the testis with varicocele and the need for surgery.

Keywords:
Testis, Varicocele, Color Doppler, PixelFlux
1.
Semiz I, Tokgöz O, Tokgoz H, Voyvoda N, Serifoglu I, Erdem Z. The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele.
Ultrasound Q
. 2014 Mar; 30(1): 33–40.
2.
Unsal A, Turgut AT, Taşkin F, Koşar U, Karaman CZ. Resistance and pulsatility index increase in capsular branches of testicular artery: indicator of impaired testicular microcirculation in varicocele?
J Clin Ultrasound
. 2007 May; 35(4): 191–5.
3.
Woźniak MM, Scholbach TM, Scholbach J, Pawelec A, Nachulewicz P, Wieczorek AP, et al. Color Doppler dynamic tissue perfusion measurement: a novel tool in the assessment of renal parenchymal perfusion in children with vesicoureteral reflux.
Arch Med Sci
. 2016 Jun; 12(3): 621–8.
4.
Wieczorek AP, Woźniak MM, Stankiewicz A, Santoro GA, Bogusiewicz M, Rechberger T, et al. Quantitative assessment of urethral vascularity in nulliparous females using high-frequency endovaginal ultrasonography.
World J Urol
. 2011 Oct; 29(5): 625–32.
5.
Scholbach T, Girelli E, Scholbach J. Dynamic tissue perfusion measurement: a novel tool in follow-up of renal transplants.
Transplantation
. 2005 Jun; 79(12): 1711–6.
6.
Scholbach T, Scholbach J, Krombach GA, Gagel B, Maneschi P, Di Martino E. New method of dynamic color doppler signal quantification in metastatic lymph nodes compared to direct polarographic measurements of tissue oxygenation.
Int J Cancer
. 2005 May; 114(6): 957–62.
7.
Scholbach T, Herrero I, Scholbach J. Dynamic color Doppler sonography of intestinal wall in patients with Crohn disease compared with healthy subjects.
J Pediatr Gastroenterol Nutr
. 2004 Nov; 39(5): 524–8.
8.
Scholbach T, Dimos I, Scholbach J. A new method of color Doppler perfusion measurement via dynamic sonographic signal quantification in renal parenchyma.
Nephron, Physiol
. 2004; 96(4): 99–104.
9.
Scholbach TM, Vogel C, Bergner N. Color Doppler sonographic dynamic tissue perfusion measurement demonstrates significantly reduced cortical perfusion in children with diabetes mellitus type 1 without microalbuminuria and apparently healthy kidneys.
Ultraschall Med
. 2014 Oct; 35(5): 445–50.
10.
Parrilli A, Roberti A, Escolino M, Esposito C. Surgical approaches for varicocele in pediatric patient.
Transl Pediatr
. 2016 Oct; 5(4): 227–32.
11.
Bogaert GA. Adolescent varicocele: limited indications for treatment during puberty and adolescence.
Transl Androl Urol
. 2014 Dec; 3(4): 398–401.
12.
Kozakowski KA, Gjertson CK, Decastro GJ, Poon S, Gasalberti A, Glassberg KI. Peak retrograde flow: a novel predictor of persistent, progressive and new onset asymmetry in adolescent varicocele.
J Urol
. 2009 Jun; 181(6): 2717–22.
13.
Diamond DA, Gargollo PC, Caldamone AA. Current management principles for adolescent varicocele.
Fertil Steril
. 2011 Dec; 96(6): 1294–8.
14.
Hassan A, Gad HM, Mostafa T. Radiologically assessed testicular changes in infertile males with varicocele.
Andrologia
. 2011 Oct; 43(5): 307–11.
15.
Suga K, Ariyoshi I, Nakanishi T, Sakatoku J, Baba Y, Takihara H. Clinical study of varicocele by sequential scrotal scintigraphy.
Andrologia
. 1990 Nov-Dec; 22(6): 525–9.
16.
Sweeney TE, Rozum JS, Gore RW. Alteration of testicular microvascular pressures during venous pressure elevation.
Am J Physiol
. 1995 Jul; 269(1 Pt 2):H37–45.
17.
Tarhan S, Gümüs B, Gündüz I, Ayyildiz V, Göktan C. Effect of varicocele on testicular artery blood flow in men–color Doppler investigation.
Scand J Urol Nephrol
. 2003; 37(1): 38–42.
18.
Tarhan S, Ucer O, Sahin MO, Gumus B. Long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow.
J Androl
. 2011 Jan-Feb; 32(1): 33–9.
19.
Balci A, Karazincir S, Gorur S, Sumbas H, Egilmez E, Inandi T. Long-term effect of varicocele repair on intratesticular arterial resistance index.
J Clin Ultrasound
. 2008 Mar-Apr; 36(3): 148–52.
20.
Ener K, Üçgül YE, Okulu E, Aldemir M, Işik E, Kayigil Ö, et al. Comparison of arterial blood supply to the testicles in the preoperative and early postoperative period in patients undergoing subinguinal varicocelectomy.
Scand J Urol
. 2015 Apr; 49(2): 169–73.
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