Shehata, O., Al-Shatouri, M., Rashwan, H., Shalaby, E., El-Sakka, A. (2025). Intra-testicular Doppler Ultrasound Parameters among Varicocele Patients: A Review. Suez Canal University Medical Journal, 28(6), 1-8. doi: 10.21608/scumj.2025.434105
Omar M. Shehata; Mohamed A. Al-Shatouri; Hashem M.. Rashwan; Essam A. Shalaby; Ahmed I. El-Sakka. "Intra-testicular Doppler Ultrasound Parameters among Varicocele Patients: A Review". Suez Canal University Medical Journal, 28, 6, 2025, 1-8. doi: 10.21608/scumj.2025.434105
Shehata, O., Al-Shatouri, M., Rashwan, H., Shalaby, E., El-Sakka, A. (2025). 'Intra-testicular Doppler Ultrasound Parameters among Varicocele Patients: A Review', Suez Canal University Medical Journal, 28(6), pp. 1-8. doi: 10.21608/scumj.2025.434105
Shehata, O., Al-Shatouri, M., Rashwan, H., Shalaby, E., El-Sakka, A. Intra-testicular Doppler Ultrasound Parameters among Varicocele Patients: A Review. Suez Canal University Medical Journal, 2025; 28(6): 1-8. doi: 10.21608/scumj.2025.434105
Intra-testicular Doppler Ultrasound Parameters among Varicocele Patients: A Review
1Department of Urology, Suez Canal University, Ismailia, Egypt
2Department of Diagnostic Radiology, Suez Canal University, Ismailia, Egypt
31Department of Urology, Suez Canal University, Ismailia, Egypt
Abstract
Background: Varicocele is characterized by the abnormal enlargement, elongation, and tortuosity of the pampiniform plexus veins, which are responsible for testicular venous drainage. While varicocele affects approximately 15% of the male population, its prevalence rises significantly among infertile men (19–41%) and reaches 70–80% in cases of secondary infertility. Although the etiology of varicocele remains uncertain, it is generally accepted as multifactorial, with proposed contributors including the nutcracker phenomenon, weak mesenchyme syndrome and defective venous valves. Aim: To explore the impact of varicocele on hormonal profiles, particularly estradiol and testosterone levels, and to assess the associated hemodynamic changes detectable by Doppler ultrasound. Materials and Methods: Previous studies assessing hormonal changes in men with varicocele, specifically those with oligoasthenoteratozoo-spermia, were reviewed. Doppler ultrasound findings evaluating peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were also analyzed in relation to varicocele presence. Results: Men with varicocele, especially those with abnormal semen parameters, have been found to exhibit elevated estradiol concentrations and reduced total testosterone levels, resulting in a decreased testosterone-to-estradiol (T: E) ratio. Additionally, varicocele has been associated with increased sperm DNA damage, adversely affecting fertility. Doppler ultrasound studies have consistently demonstrated significant alterations in testicular blood flow parameters (PSV, EDV, RI) in affected individuals. Conclusions: Varicocele contributes to hormonal imbalances and impaired sperm parameters, leading to reduced fertility. Evaluation using Doppler ultrasound aid in detecting hemodynamic abnormalities, and surgical intervention such as subinguinal varicocelectomy help restore hormonal balance and improve fertility.
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