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[Clinical studies of varicocele. 2: Radiographic examination and measurement of spermatic vein pressure in varicocele patients].

There are two types of internal spermatic veins (ISV) by radiographic examinations. In type 1, ISV is dilated with some collateral venous branches. On the other hand, ISV of type 2 is narrowed with increased collateral venous branches or abnormalities such as the circumaortic renal are seen. In these groups, pressure of renal vein and ISV were measured. As a result, renal vein pressure was about the same in type 1 as in the controls at 9.5 +/- 2.3 cmH2O but was higher in type 2 at 17.0 +/- 2.8 cmH2O. As for ISV, it was also about the same in type 2 as in the controls at 13.9 +/- 6.8 cmH2O but was markedly higher in type 2 at 33.3 +/- 3.9 cmH2O. When selective renal venography was performed, a contrast medium back-flow was seen in 9 out of 11 type 1 varicocele patients, but it was not seen in any of the cases with the nutcracker phenomenon. These results suggested that type 1 may be caused by the structural and functional disorders in the valve between the renal vein and ISV. In contrast, pathogenesis of type 2 varicocele may be due to an abnormality of the ISV in the embryo.