Varicocoele grading on colour Doppler

Varicocoele grading on colour Doppler can be done variably. The most elaborate and widely-accepted grading was given by Sarteschi, as below. 

For a general discussion of this condition refer to the article: varicocoele.

Evaluation

  1. baseline grey scale study in supine position and measure the diameters of veins, total diameter of plexus
  2. next colour Doppler and see reflux during Valsalva manoeuver
  3. repeat in standing position

Grading of varicocele

  • grade I
    • no dilated intrascrotal veins
    • reflux in spermatic cord veins of the inguinal region during Valsalva manoeuvre
  • grade II
    • prominent veins at upper pole of testis
    • reflux at upper pole veins during Valsalva manoeuvre
  • grade III
    • no major dilatation in supine position
    • dilated veins up to lower pole of testis seen only in standing position
    • reflux at lower pole veins during Valsalva manoeuvre
  • grade IV
    • dilated veins even in supine position
    • reflux during Valsalva manoeuvre
  • grade V
    • dilated veins
    • reflux without Valsalva manoeuvre

Classification according to Sarteschi is 3

  • grade I: reflux at the level of groin only during the Valsalva manoeuvre, without scrotal deformation or testicular hypotrophy

  • grade II: reflux at the level of the proximal segment of the pampiniform plexus only during the Valsalva manoeuvre, without scrotal deformation or testicular hypotrophy

  • grade III: reflux in the distal vessels at the level of lower scrotum only during the Valsalva manoeuvre, without scrotal deformation or testicular hypotrophy

  • grade IVa: spontaneous reverse flow, increasing during the Valsalva manoeuvre, with scrotal deformation and possible testicular hypotrophy

  • grade V: resting reflux in the dilated pampiniform plexus, possibly increasing during the Valsalva manoeuvre, always accompanied by testicular hypotrophy

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Article information

rID: 26661
Section: Staging
Synonyms or Alternate Spellings:
  • Varicocele grading on colour Doppler Ultrasound
  • Grading of varicocele
  • Grading of varicocoele

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