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J Korean Androl Soc. 1991 Dec;9(2):117-125. Korean. Original Article.
Choi HK , Kim YC .
Department of Urology, Yonsei University Medical College, Korea.

The relationship between the varicocele and the erectile failure has not yet been fully elucidated, but clinically it is not uncommon to see the patients in which these two conditions coexist. Recently we developed a new diagnostic method, which we call "scroto-penogram"-a concomitant study for the varicocele and the erectile failure. We evaluated 289 impotent patients, 54(18.7%) had varicocele and 235 had no varicocele. The results are as follow. 1. In the etiological subclassification of the erectile, the incidence of the hormonal impotent patients with varicocele was higher than without varicocele. 2. After the ligation of the left internal spermatic vein, the type of the audiovisual stimulation(AVS)-penoram(57.1%, 8 among 14) and the subjective symptoms(65.2%, 15 among 23) were improved. 3. The type of the AVS penogram(3 among 3), Rigiscan(2 among 3), subjective symptoms(4 among 4), response of the GnRH test(2 among 2) and the level of serum testosterone(1 among 2) of 4 hormone impotent with varicocele patients were improved after operation. The above results might suggest that the psychological and endocrinological factors were significantly involved in the relationship between these two conditions. To clarify the endocrinological effect of varicocele on erectile failure, further studies in the hormonally impotent with varicocele patients may be needed. And varicocele results secondary to incompetent or abscent valves in the spermatic veins, so we cannot rule out the association with the incompetence of the penile vein. To clarify the association with the incompetence of the penile vein, further studies such as dynamic infusion carvernosometry and carvernosography in the venogenic impotent with varicocele patients may be needed.

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