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AJR 2004; 183:1379-1385
© American Roentgen Ray Society

Testicular Size and Vascular Resistance Before and After Hydrocelectomy

Ismail Mihmanli1, Fatih Kantarci1, Haluk Kulaksizoglu2, Bengi Gurses1, Gunduz Ogut1, Erdinc Unluer2, Omer Uysal3 and Ayca Altug1

1 Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34300, Turkey.
2 Department of Urology, SSK Istanbul Hospital, Istanbul 34300, Turkey.
3 Department of Biostatistics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34300, Turkey.

OBJECTIVE. We sought to determine whether there is an association between hydroceles and testicular size and vascular resistance.

SUBJECTS AND METHODS. Twenty-three patients with a mean age of 42.8 years who had a unilateral idiopathic hydrocele and who underwent unilateral hydrocelectomy were included in the study. Testicular size and resistive (RI) and pulsatility (PI) indexes of the intratesticular arteries on the involved and uninvolved sides were measured before and after the hydrocelectomy.

RESULTS. We found statistically significant differences in the testicular volumes between the normal side (mean ± SD, 15.40 ± 3.41 mL) and the side with the hydrocele (20.67 ± 4.01 mL) before surgery (p < 0.001) and in the volumes in the side with the hydrocele before (20.67 ± 4.01 mL) and after (16.20 ± 2.99 mL) surgery (p < 0.001). No such a difference in volume was seen in the normal side before (15.40 ± 3.41 mL) and after (15.28 ± 3.24 mL) surgery (p = 0.200). The mean decrease in volume in the testis with the hydrocele after hydrocelectomy was 21%. There were statistically significant differences of RI and PI values between the normal testis (0.59 ± 0.07 and 1.02 ± 0.34, respectively) and the testis with hydrocele (0.79 ± 0.11 and 1.70 ± 0.56, respectively) before surgery (p < 0.001). In the testis with the hydrocele, we found a statistically significant decrease in RI and PI values (0.62 ± 0.05 and 1.00 ± 0.14, respectively) of intratesticular arteries after surgery (p < 0.001). The mean decreases in RI and PI values after hydrocelectomy were 21% and 36%, respectively.

CONCLUSION. There is an association between the development of an idiopathic hydrocele and testicular size and vascular resistance. We believe that the increase in volume and vascular resistance is due to an increase in impedance to venous and lymphatic flow.


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