Clinical Application of 'Scrotogram'

Shin, Jae Seop; Kim, Young Chan; Choi, Hyung Ki; Cha, Kwang Yul

Abstract

A study was undertaken during the past 2 years of patients who visited the infertility clinic of this hospital. The patients included those with male infertility, scrotal mass, scrotal pain or impotence. These patients were studied by means of reviewing the clinical applications of 'Scrotogram' and the following results were obtained. A total of 122 cases underwent a 'Scrotogram' study and among them 80 cases were diagnosed as varicocele, which included 14 cases( 18%) of subclinical varicocele which are difficult to be diagnosed by initial physical examination. There was statistical significance in the varicocele index between the control group and the Grade I varicocele group(p<0.01) and between the control group and subclinical varicocele group(p<0.01), and between the Grade I and Grade II group.(p<0.01), and between the Grade II and Grade II group(p<0.05). Among 66 clinical varicocele patients, 63 cases(80% ) were diagnosed by varicocele index, and 54 cases(82% ) were diagnosed by static image. A combination of the above two methods allowed 61 cases(92%) to be diagnosed. Among 48 patients who underwent high ligation of internal spermatic vein, 25 patients were subject to postoperative follow-up 'Scrotogram', which revealed 12 cases with excellent results, 8 cases with good results, and 5 cases with poor results. The average varicocele index before and after surgery was 1.78 and 1.24 and there were statistical significance(p<0.01). There was statistical significance, in sperm count and motility between the control group and clinical varicocele group(p <0.01) and between the control group and subclinical varicocele group(p <0.01). However, there appeared no statistical significance in semen character between the clinical varicocele and subclinical varicocele group. Among the 13 patients who were subject to postoperative follow-up semen analysis 11 patient showed improved results, and there was marked improvement in sperm count(p<0.05). There was slight improvement in sperm motility and morphology but showed no statistical significance. At present, 2 patients were impreged. Among 110 patients with infertility and olieoasthenoteratozoospermia, 22 were initially diagnose as varicocele by physical examination only, and 7 patients were diagnosed as subclinical varicocele after a 'Scrotogram' was taken. In conclusion, the 'Scrotogram' is able to identify varicocele objectively, and also identify subclinical varicocele which is an important contributing factor to male infertility. Also, this method of study is able to assess the postoperative result of varicocele accurately.