Comparison of Four Different Methods for the Diagnosis of Varicocele

While the diagnosis of large varicoceles should not cause any problems, small varicoceles are often more difficult to detect on clinical palpation. Besides, some patients do present reflux in the internal spermatic vein without palpable distension of the pampiniform plexus [1]. Four objective techniques are available to diagnose such subclinical reflux. Scrotal thermography, Doppler blood-flow measurement and testicular perfusion analysis using radioisotopes are non-invasive, and useful for routine patient screening, whereas retrograde venography of the internal spermatic vein should be reserved for selected cases.