Should varicocele screening be conducted in men diagnosed with chronic venous insufficiency? A prospective study.

IF 0.6 Q4 SURGERY Kardiochirurgia I Torakochirurgia Polska Pub Date : 2024-03-01 Epub Date: 2024-03-30 DOI:10.5114/kitp.2024.138486
Ferit Çetinkaya, Kamil Doğan, Ayşe Taş
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Abstract

Introduction: It has been previously proposed in numerous studies that chronic venous insufficiency (CVI) has similar pathogenesis to varicocele in males. Varicocele has been identified as the most common cause of infertility in men, accounting for 40% of cases.

Aim: This study investigates whether varicocele screening should be conducted in patients with CVI and, if so, which patients should undergo such screening.

Material and methods: The study included 102 adult male patients with venous insufficiency complaints who presented to the cardiovascular surgery clinic between January 2023 and June 2023. Data were prospectively collected through medical history interviews and Doppler ultrasound measurements performed by a single radiologist. The relationship between non-normally distributed measurement data of the two groups was evaluated using the Mann-Whitney U test, while the association between categorical variables was assessed using the χ2 test. ROC analysis was employed for determining predictive value. A type 1 error level of α = 0.05 was adopted.

Results: The mean left great saphenous vein (GSV) diameter of those with varicocele (6.6 ±2.3) was significantly larger compared to the mean left GSV diameter of those without varicocele (5.3 ±2.6) (p = 0.004). The area under the ROC curve for left GSV diameter was 67% (p = 0.005). When varicocele screening is performed in patients with a left GSV diameter of 5.35 cm and above, sensitivity is 71.4% and specificity is 61.2%.

Conclusions: There is a significant association between left GSV diameter and varicocele (p = 0.004). Varicocele screening can be carried out with 71.4% sensitivity in adult male patients with a left GSV diameter of 5.35 cm and above. Both cardiovascular surgeons and radiologists can conduct varicocele screening by measuring pampiniform veins in patients with a left GSV diameter of 5.35 cm and above. This approach has the potential to reduce the incidence of varicocele and associated infertility.

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是否应对被诊断为慢性静脉功能不全的男性进行精索静脉曲张筛查?一项前瞻性研究。
导言:以前有许多研究提出,慢性静脉功能不全(CVI)与男性精索静脉曲张的发病机制相似。精索静脉曲张已被确定为导致男性不育的最常见原因,占不育病例的 40%。目的:本研究探讨是否应对 CVI 患者进行精索静脉曲张筛查,如果是,哪些患者应接受此类筛查:研究对象包括2023年1月至2023年6月期间到心血管外科门诊就诊的102名静脉功能不全的成年男性患者。数据通过病史访谈和由一名放射科医生进行的多普勒超声测量进行前瞻性收集。两组非正态分布测量数据之间的关系采用 Mann-Whitney U 检验进行评估,分类变量之间的关联采用 χ2 检验进行评估。采用 ROC 分析法确定预测值。采用的 1 型误差水平为 α = 0.05:结果:患有精索静脉曲张者的平均左大隐静脉(GSV)直径(6.6 ± 2.3)明显大于无精索静脉曲张者的平均左大隐静脉直径(5.3 ± 2.6)(P = 0.004)。左侧 GSV 直径的 ROC 曲线下面积为 67% (p = 0.005)。如果对左侧 GSV 直径为 5.35 厘米及以上的患者进行精索静脉曲张筛查,敏感性为 71.4%,特异性为 61.2%:结论:左侧 GSV 直径与精索静脉曲张之间存在明显关联(p = 0.004)。对于左侧 GSV 直径在 5.35 厘米及以上的成年男性患者,精索静脉曲张筛查的灵敏度为 71.4%。心血管外科医生和放射科医生都可以通过测量左侧GSV直径在5.35厘米及以上的患者的瓣膜静脉来进行精索静脉曲张筛查。这种方法有可能降低精索静脉曲张和相关不育症的发病率。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.
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