The use of scrotal ultrasound in the evaluation of varicoceles: A survey study of reproductive specialists

Authors

  • Jabez C. Gondokusumo Scott Department of Urology, Baylor College of Medicine, Houston, TX
  • Mohit Butaney Department of Urology, Mayo Clinic, Rochester, MN
  • Adithya Balasubramanian Scott Department of Urology, Baylor College of Medicine, Houston, TX
  • Jonathan A. Beilan Scott Department of Urology, Baylor College of Medicine, Houston, TX
  • Alexander J. Tatem Scott Department of Urology, Baylor College of Medicine, Houston, TX
  • Nannan Thirumavalavan University Hospitals Urology Institute, Case Western Reserve University, Cleveland, OH
  • Alexander W. Pastuszak Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
  • Larry I. Lipshultz Scott Department of Urology, Baylor College of Medicine, Houston, TX

DOI:

https://doi.org/10.5489/cuaj.6147

Keywords:

Varicocele, ultrasonography, surveys and questionnaires, male infertility

Abstract

Introduction: Urologists use ultrasound in the male infertility workup to evaluate scrotal contents and objectively identify varicoceles if their presence is questionable on physical examination. We assessed practice patterns and diagnostic criteria of male reproductive urologists using ultrasound to evaluate varicoceles.

Methods: An anonymous online survey was sent to the Society for Male Reproduction and Urology (SMRU) members. We queried respondents about ultrasonographic criteria and ultrasound techniques employed in varicocele evaluation. Chi-squared was used to determine association between categorical variables.

Results: In total, 110/320 (34.4%) SMRU members responded. Sixty percent of respondents (66/110) reported performing scrotal ultrasound; 92.4 % (61/66) were attending urologists and 87.9% (58/66) completed an andrology fellowship. A total of 37.9% (25/66) performed their own ultrasound, while the remainder had ultrasound performed by an alternate practitioner. Among those performing their own ultrasound, 95.5% (21/22) measured varicocele venous diameter compared to 76% (29/38) when another practitioner performed the ultrasound. Venous diameter used to define a varicocele ranged from 2–4 mm. Although 80% (49/61) of respondents assessed retrograde flow during ultrasound, only 52.5% reported that retrograde flow was required for varicocele diagnosis. Almost all (60/61) indicated they would fix palpable varicoceles in patients with abnormal semen parameters. Fewer (42.6%, 26/61) respondents stated they would repair varicoceles found exclusively on ultrasound.

Conclusions: Ultrasound is commonly employed by male reproductive urologists to diagnose varicoceles. We identified that practitioners use various ultrasonographic criteria and techniques for varicocele diagnosis. Study limitations include recall bias and high degree of specialization among respondents.

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Published

2020-03-23

How to Cite

Gondokusumo, J., Butaney, M., Balasubramanian, A. ., Beilan, J., Tatem, A., Thirumavalavan, N., Pastuszak, A., & Lipshultz, L. (2020). The use of scrotal ultrasound in the evaluation of varicoceles: A survey study of reproductive specialists. Canadian Urological Association Journal, 14(8), E258–62. https://doi.org/10.5489/cuaj.6147

Issue

Vol. 14 No. 8 (2020): CUAJ August

Section

Original Research

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