Background Varicocele is the first cause of male sub-fertility and it is well know its correlation with testicular growth arrest. In paediatric age testicular hypotrophy is the main indication for surgical treatment. The aim of this study is to evaluate the role of elastosonography in the evaluation of testicular elasticity as predictive sign of testicular damage.
Materials and methods 13 boys (9–13 years old) with untreated varicocele (bilateral in 3 boys and left unilateral in 10) and 12 age-matched healthy subjects underwent elastosonography. Varicocele was classified following the Dubin and Amelar classification and spermatic vein reflux was classified following a modified Hirsch classification (as short, medium and continuous spermatic vein reflux). The testicular elasticity was expressed as a three-point scale (1: normal; 2: slightly to moderately stiffer than normal; 3: severely stiffer than normal). None had testicular hypotrophy. Statistical analysis was performed by means of the Student’s t-test.
Results 2 patients had grade I varicocele, II in 9 patients had grade II varicocele and 5 patients had grade III varicocele; 3 cases had “short£ spermatic vein reflux, 6 patients had “medium” spermatic vein reflux and 7 patients had continuous spermatic vein reflux. The elasticity was 1 in all 34 normal testes; in the testes with varicocele it was graded 2 in 9 cases and 3 in 7 cases. The differences in the degree of elasticity between normal testes and testes with varicocele and between continuous and medium/short spermatic vein reflux were highly significant (p < 0.001 in both cases); the difference between stage III and stages I/II varicocele was just below significance (p = 0.053).
Conclusion Testes with varicocele are significantly stiffer than normal ones, with a positive correlation to the clinical grade and significantly to the duration of spermatic vein reflux.