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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


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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.

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