The characteristics of the prostate and gonadal microcirculation in the adolescents with isolated varicocele and varicocele with the pelvic congestion

Varicocele is one of the frequent diagnosis in the adolescents, which carries a high risk of the infertility. Aim of the investigation: to evaluate the characteristics of the microcirculation in the prostate and gonads of the adolescents with isolated varicocele and varicocele with the pelvic congestion using laser Doppler flowmetry (LDF). Materials and methods: 60 adolescents was included in the analysis who had left-side varicocele; in the first group - 30 patients with isolated varicocele, in the second group - 30 patients with combination of the varicocele and the venous congestion in the periprostatic plexus of the small pelvis. Control group included 15 volunteers without andrological diseases. The status of the prostate and gonads were estimated using LDF-derived microcirculation state analysis. Results: the significant differences could be observed in the microcirculation state of the left testis in all groups in comparison with the control group in form of the reduce in the mean flow and increase of the shunting index (SI). In the second group the decrease in mean flow, low index of the microcirculation efficacy (IME) and increase in SI were present. Prostate hemodynamics was similar in the group 1 and control group and was statistically significant different between group 2 and control group. Conclusions: isolated varicocele is linked to the alterations in the microcirculation predominately in the left testis with the minimal alterations in the right testis and without the alterations of the prostate flow. Varicocele with the pelvic congestion involve in the pathologic process not only the left testis, but also the contralateral testis and prostate.