Radiological features of the Left spermatic vein in adolescent Varicocele

Background: The reason for study was to investigate the feasibility of the left spermatic vein in adolescents with varicocele. Objective: The objective was to analyze and classify the venographic types of insufficiency according to Sigmund's modification of Bahren venographic types. Material and methods: A retrospective-prospective study was conducted in 190 male adolescents ranging 16-18 years diagnosed with varicoceles. Transfemoral spermatic phlebography on the left was performed and radiological morphology of the internal spermatic vein was analyzed: the number and the course of the veins, variation of the connection to the left renal vein, and the collaterals. Results: The overall number of patients was 190. Four patients (2.1%) had no renospermatic reflux. Ten patients (5.3%) have two or more spermatic veins. Variations of vein connection were noticed in eight patients (4.3%). Three patients had competent valve at the vein origin and the reflux noticed via the collateral branches connected to renal veins. Collateral branches were visualized to renal, to perirenal, lumbar and other sites. Conclusion: Left spermatic veins differ significantly in morphology: most importantly there were the collateral veins (29.0%) toward other venous basin.