Varicocele grading on color Doppler
Varicocele grading on color 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: varicocele.
Evaluation
Grading of varicocele
- grade I
- no dilated intrascrotal veins
- reflux in spermatic cord veins of the inguinal region during Valsalva maneuver
- grade II
- prominent veins at upper pole of testis
- reflux at upper pole veins during Valsalva maneuver
- 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 maneuver
- grade IV
- dilated veins even in supine position
- reflux during Valsalva maneuver
- grade V
- dilated veins
- reflux without Valsalva maneuver
Classification according to Sarteschi
grade I: reflux at the level of groin only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade II: reflux at the level of the proximal segment of the pampiniform plexus only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade III: reflux in the distal vessels at the level of lower scrotum only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade IV: spontaneous reverse flow, increasing during the Valsalva maneuver, with scrotal deformation and possible testicular hypotrophy
grade V: resting reflux in the dilated pampiniform plexus, possibly increasing during the Valsalva maneuver, always accompanied by testicular hypotrophy