Abstract / Summary
Abstract Varicocele is a common and reversible cause of male infertility, affecting many men. It can lead to testicular dysfunction through venous reflux, hyperthermia, oxidative stress, and hormonal imbalance. Traditional imaging methods, like ultrasound, primarily assess anatomical changes but miss early tissue alterations. Shear wave elastography (SWE) is a noninvasive technique that quantitatively measures testicular stiffness, helping to detect early microstructural changes before permanent damage occurs. This cross-sectional comparative study evaluated testicular stiffness using SWE in patients with and without varicocele. Stiffness values were measured at different poles and compared between groups. The study also assessed the correlation between stiffness and varicocele severity, testicular volume, and semen parameters. Additionally, pre- and postoperative SWE values were compared in a subset of patients to assess changes following varicocelectomy. Patients with varicocele exhibited higher testicular stiffness values than controls, indicating possible parenchymal damage. There was a positive correlation between varicocele severity and stiffness, along with reduced testicular volume and impaired semen parameters, pointing to compromised spermatogenesis. Postoperative assessments showed improved stiffness in some patients, suggesting partial reversibility of testicular changes after treatment. SWE is a promising, noninvasive imaging modality for the evaluation of testicular stiffness in patients with varicocele. It provides valuable functional information beyond conventional imaging and may serve as an early indicator of testicular damage. SWE has potential clinical utility in diagnosis, prognostication, and monitoring treatment response in varicocele, thereby aiding in better management of male infertility.