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A Journal on Phlebology
Acta Phlebologica 2002 December;3(3):131-5
language: English, Italian
Presence and physiopathologic meaning of valvulae venosae and of subintimal PADS in pampiniform plexuses in idiopathic varicocele
Soda G. 2, Bosco M. R. 1, Melis E. 2, Meschini E. 1, Gioffrè L. 1
1 Dipartimento di Scienze Chirurgiche e Tecnologie Mediche Applicate, Università degli Studi "La Sapienza" - Roma ;
2 Dipartimento di Medicina Sperimentale e Patologia
BACKGROUND: Morphological research has been carried out on the venous plexuses of patients operated on for varico- cele.
METHODS: The study was carried out on 10 plexuses removed surgically in patients suffering from idiopathic varicocele.
RESULTS: The anatomopathological observations show that the changes do not involve all the vessels of the plexus in which a diffuse, albeit irregular, dyselastosis process may be evident. In the internal wall two principal configurations are to be found: regular undulations of the wall, a premise of functional adaptation, or fibroelastic prominences starting from the internal elastic membrane which could perform a valve-like action. In small lumen vessels we observed normally shaped valve apparatus; in higher lumen vessels also, we observed the presence of valves, at times with an irregular conformation. Also highlighted was a pampiniform morphofunctional vascular unit with central artery and satellite veins; the ectasic modification of these satellite veins involves a peripheral shift of the artery in the altered plexuses.
CONCLUSIONS: Apart from being related to the degree, the anatomopathological lesions could be correlated to the duration of the reflux and therefore to the time of onset of varicocele and, at least at the beginning, have a reactive significance of adaptation to the greater hypertensive regime irregularly distributed in the plexus vessels.