Evaluation of varicocele frequency of patients with spinal cord injury by color Doppler ultrasonography: A new etiological factor for varicocele?

Purpose: To evaluate the varicocele frequency of patients with spinal cord injury by color Doppler ultrasonography. Materials and methods: Sixty patients {48 patients with upper motor neuron injury (U-MNI) and 12 patients with lower-MNI} with traumatic spinal cord injury and age matched 48 healthy volunteers were enrolled in this prospective study. Testis volumes and varicocele grades were determined. Presence of varicocele was also classified according to clinical significance. Results: Testis volumes of U-MNI sub-group (14.81 ± 4.74 ml) were significantly smaller than the control group (18.20 ± 4.52 ml, p = 0.000) and L-MNI sub-group (17.88 ± 3.23 ml, p = 0.008). No left-sided clinical varicocele was found in L-MNI sub-group (0/12, 0%), whereas there were 14 patients in control group (14/48, 29%) and 7 patients in U-MNI sub-group (7/47, 15%), and the difference was statistically significant (p = 0.000, 0.007, respectively). Conclusion: Clinical varicocele frequency of U-MNI patients, who have spastic paralysis of abdominal and lower extremity muscles, is similar to the control group. This finding inspires that increased intra-abdominal pressure via normal to increased abdominal muscle tonus may have a role in the varicocele etiology, beside the classical factors. Absence of clinical varicocele in L-MNI patients, who have flaccid paralysis of the same muscle groups, supports this observation