Can a scrotum ultrasound report indicate varicocele?

Question

Hello doctor,

I had a scrotum ultrasound done and am yet to get a formal result but attaching summary images. I want to understand the result and what it means concerning varicocele. Some doctors said it is grade one varicocele while others say it is normal with the Valsva maneuver. I am worried about the 2.5 mm diameter with the Valsva maneuver done during an ultrasound before that. The value at rest is 1.8 mm which is less than 2 mm. So I am kind of confused and not able to get the correct diagnosis. Please let me know the impact on fertility if it is mild or low varicocele.

Kindly help.

Thank you.

Answer 1

Hello,

We will pay close attention to your worries and address all of your questions with utmost care.

I have read your query and am sorry for such discomfort.

Let me take a look at your laboratory reports and guide you after reading them. The ultrasound Doppler is yet to be reported. I will guide you in general about the varicocele.

I hope you had a pleasant experience with icliniq.

I will always be available for you in case you have any queries.

Thank you.

Answer 2

Hello,

Once more, thank you for allowing us to be of service to you.

We value the high level of confidence you have in us!

In the ultrasound Doppler examination:

There is an increased value with Valsalva on the right scrotal venous plexus, and the left one appears normal with and without Valsalva. We generally interpret the report provided by the sonologist and link it with the clinical presentation of the patient. The existence of veins larger than 2 mm is a commonly used ultrasound criterion for diagnosing varicocele, with a sensitivity of 95 %.

Do you have any clinical symptoms like dragging discomfort that is worse on standing at the end of the day?
Why did you get the above test done?

Varicoceles are common, affecting 10 to 20 percent of adult males, 90 percent are left-sided, and the presence of an isolated right-sided varicocele is extremely rare. Your ultrasound Doppler with Valsalva is more on the right than the left side. I have doubts about whether it is a subclinical varicocele or not. A varicocele is an abnormal dilatation and enlargement of the scrotal venous plexus draining the testis. The following classification of varicocele is useful in clinical practice:

Subclinical: not palpable or visible at rest or during a Valsalva maneuver, but can be shown by special tests (Doppler ultrasound studies);

Grade 1: Palpable during Valsalva maneuver, but not otherwise.

Grade 2: Palpable at rest, but not visible.

Grade 3: Visible and palpable at rest.

The exact association between reduced male fertility and varicocele is unknown, and usually, large varicocele is linked with low sperm count affecting male fertility. Your testosterone level is 614 ng/dl, which is normal, and it should not worry you. You should get a semen analysis test done if you are worried too much, and based on the present laboratory reports, it would also come normal. Please follow up with the ultrasound Doppler report to guide as necessary or indicated. Please follow up if you have any further related queries about it.

Thank you.