ORIGINAL ARTICLES   

Acta Phlebologica 2002 December;3(3):131-5

Copyright © 2002 EDIZIONI MINERVA MEDICA

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.