Evaluation of diameter of lumbar vein, renal vein, and gonadal vein in left kidney nephrectomy on the back tableand its relationship with the prevalence of varicocele

Abstract

The incidence of varicocele is about 40% in male patients. Varicocele is caused by dilation and twisted veins of the pampiniform network in the return flow into the internal spermatic vein, and is considered as a potential cause of male infertility. There are various theories about the pathophysiology of varicocele, including valve dysfunction and increased vascular pressure. In studies, has been reported that 90% of varicoceles occur on the left side, which is the cause of increased testicular vein resistance and decreased blood flow and accumulation in the pampiniform venous network. Although many studies have been conducted on humans and animal models, the exact mechanism of varicocele is not well understood. Therefore, understanding the etiology and accurate knowledge of the anatomical changes of this disease is important. In the present study, we examined the normality of the diameter of the lumbar vein, renal vein, and gonadal vein in left kidney nephrectomy on back table and its relationship with the prevalence of varicocele, so that by better understanding the mechanism of varicocele formation, we can influence the success of surgery and the recurrence rate of varicocele.

. Methods: This study was conducted on 30 male donors (18 to 65 years old) of the left kidney during a period of 18 months in Imam Reza Tabriz Hospital who underwent open nephrectomy surgery. Before the operation, the data related to age, BMI and presence of varicocele and its grade with physical examinations and during the operation, the diameter of the lumbar vein, renal vein, and gonadal vein was measured on a back table with a graduated ruler and recorded in a structured checklist. After three months of nephrectomy, the patients were evaluated again for varicocele

Results: In the present study, showed that the diameter of the lumbar vein, renal vein and gonadal vein were evaluated during the operation. Lumbar vein diameter does not change with increasing grading. Renal vein diameter is smaller with increasing grading (P = 0.05).And the diameter of the gonadal vein increases with increasing grading (P = 0.04). Also, the frequency of varicocele increased from 33.4% to 50% three months after nephrectomy.