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A Journal on Phlebology

Official Journal of the Italian College of Phlebology
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Acta Phlebologica 2002 August;3(2):59-63

language: English

The hae­mod­y­nam­ic alte­ra­tion of the sub­di­a­phrag­mat­ic ­venous func­tion­al ­unit and its ­role in the etio­path­o­gen­e­sis of the idiopath­ic varic­o­cele

Gioffrè L. 1, Bosco M. R. 1, Meloni V. 1, Vietri F. 1, Menchini Fabris G. F. 2

1 Cattedra di Chirurgia Generale, Dipartimento di Scienze Chirurgiche e Tecnologie Mediche Applicate, Università ­degli Studi “La Sapienza”, Roma;
2 Unità Operativa Autonoma di Andrologia, Dipartimento di Medicina del­la Procreazione e dell’Età Evolutiva, Università ­degli Studi di Pisa, Pisa


The aim of ­this ­work was to clear­ly illus­trate ­that the hae­mod­y­nam­ic path­o­gen­e­sis of the varic­o­cele can be a con­se­quence of a ret­ro­grade ­flux ­along the inter­nal sper­mat­ic ­vein. The ­reflux is due to the use of a dif­fer­ent ­path of ­flow ­along the inter­nal sper­mat­ic ­vein ­which ­uses ­some col­lat­er­al ­routes of the ves­sel, and main­ly the neph­ro­gen­i­tal ­branch. The dimin­ish­ing pres­sure in the ­final seg­ment of the inter­nal sper­mat­ic ­vein is the ­focal ­point of the path­o­gen­e­sis of the dis­ease. The onto­ge­net­ic pro­cess ­leading to the for­ma­tion of the ­left ­renal ­vein ­help that ­lead in explain­ing the ­almost gen­er­al one-sid­ed­ness of the dis­or­der, its fre­quen­cy and the ­fact ­that it is most­ly the ­young who are affect­ed by it. In ­fact, the var­i­abil­ity of the tim­ing and of the exten­sion of the invo­lu­tion of the prim­i­tive ­venous ­system and of the pro­cess­es of evo­lu­tion ­which ­lead to the mor­pho­log­i­cal def­i­ni­tion of the ­tracts of the gen­i­tal ­flow ­down, ­lead to the var­i­ous man­i­fes­ta­tions of the idiopath­ic varic­o­cele. This the­o­ry ­which ­also ­takes ­into ­account the phys­io­log­i­cal mech­a­nism of the ­venous drain­age of the tes­ti­cle in an ­anti-grav­i­ta­tion ­sense is ­part of the pat­terns ­that, ­under the dia­phragm, ­rule the ­entire ­venous ­return of the ­blood ­toward to the ­heart.

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