الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Varicocele is the most correctable cause of male infertility. It is defmed as an abnormal dilatation of the pampiniform plexus of veins, resulting from absence or incompetet valves of the internal spermatic vein. This work was performed on 50 patients, their ages ranged between 22 and 43 years, with a history of infertility ranged from 2 to 11 years. Semen analysis showed evidence of stress pattern. Twelve of these patients had a history of previous operation for treatment of varicoceles. The clinically detected varicoceles are classified into 3 grades according to their size, as in grade I, the varicocele was palpable only at Valsalva’s maneuver, in grade II, varicocele was palpable at quite breathing and increased by Valsalva’s maneuver, while in grade III, it was visible and palpable at quite breathing and also increased by Valsalva’s maneuver. Gray scale sonographic examination confirmed the diagnosis of the clinically detected varicocele, in addition to the demonstration of 11 out of 15 patients who were negative for varicocele by clinical examination. These patients were called subclinical varicoceles. Sonographic grading of varicoceles was done considering the diameter of the dominant vein in the pampiniform plexus of the affected side. In grade I varicocele, the diameter of the dominant vein in pampiniform plexus ranged between 2.5 and 4 mm, in grade II, it ranged from 4 to 5 mm., while in grade III the dominant vein diameter was more than 5 mm. Duplex Doppler and color Doppler sonography were done for our patients, revealed the presence of varicocele in 49 patients, while the remaining patient was negative for varicocele. Three different types of venous wave forms were detected, a continuous or permanent wave that (seen before, increased during and continued after Valsalva’s maneuver), was detected in 30 patients. Another venous activity with initial increase during Valsalva’ s maneuver and stopped after short time was noticed in 17 patients, while a small intermittent wave had occurred in 2 patients. Internal spermatic venography was performed for 50 patients showed the detection of 46 (92%) patients with varicoceles included a subclinical case which was not diagnosed by gray scale or Doppler.