The value of scrotal infrared digital thermography in detection of varicocele - initial results

Introduction: Varicocele is a dilatation of pampiniform venous plexus. It is associated with male infertility, as it is found in more than 40% of male partners in infertile couples. The main pathophysiological mechanism for impaired spermastogenesis is considered to be elevated scrotal temperature. Mainstay for diagnostic assessment of varicocele is physical examination and scrotal ultrasound/doppler Thermography is a diagnostic method which measures temperature differences across the skin surface using a highly sensitive infrared camera. Currently there is no consensus regarding diagnostic parameters for thermography in diagnosis of varicocele. Aim of this study is to examine application of digital thermography in diagnosing varicocele. Material and Methods: Study group consisted of 10 patients of mean age 18.2 +/- 2.4 (range = 15.5 to 23.7). In all patients varicocele was detected incidentally on routine physical examination. All patients were evaluated by three methods. Infrared digital thermography was followed by physical examination and ultrasound/doppler Infrared camera Thermo Tracer TH7102WL (NEC Sanei Instruments, Ltd., Japan) was used during all measurements. This infrared system has a geometric resolution of 76.800 pixels per picture (320 x 240) and the minimum detectable temperature resolution (difference) is 0.07 degrees C at 30 degrees C (Normal mode). Results: Mean temperature at left pampiniforum plexus was 34.65 +/- 0.66 degrees C (range = 34.1 to 36.3 degrees C) and at right pampiniform plexus 32.53 +/- 0.78 degrees C (range = 31.5 to 33.5 degrees C). Temperature at left testicle was 33.58 +/- 0.97 degrees C (range = 32.1-35 degrees C) while at right testicle it was 32.19 +/- 0.81 degrees C (range = 31.2 to 33.5 degrees C). Temperature at pampiniform plexus higher than 34 degrees C presents main thermographic sign of varicocele, while temperature at testicle higher than 32 degrees C is indicative of varicocele. Temperature difference between left and right pampiniform plexus was 2.12 +/- 1.08 degrees C (range = 0.9 to 4.7 degrees C), and between testicles was 1.39 +/- 1.20 degrees C (range = 0.1 to 3.6 degrees C). Thermography successfully confirmed varicocele diagnosis in all patients. Conclusion: Digital infrared thermography presents feasible and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method and to establish consistent diagnostic parameters for thermographic assessment of varicocele.