Recurrent varicocele and May-Thurner syndrome

• Published in: Vestnik urologii (Online) Vol. 6; no. 3; pp. 17 - 25
• Main Authors: Zhukov, O. B., Ukolov, V. A., Babushkina, E. V., Evdokimov, V. V.
• Format: Journal Article
• Language: English; Russian
• Published: Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education 27.10.2018
• Subjects: chronic pelvic pain; may-thurner syndrome; phlebotonometry; selective phlebography of the iliac veins; varicocele; varicose disease of the pelvis in men; wreath-occlusive erectile dysfunction
• ISSN: 2308-6424; 2308-6424
• DOI: 10.21886/2308-6424-2018-6-3-17-25

Introduction. May-Thurner syndrome is a complex disease diagnosed. Most often this disease manifests itself in chronic pelvic and testicular pain or pain in the left leg. Also, this syndrome can cause an unstable erection and cause infertility against a tense varicocele. Purpose of the study. Optimization of the management strategy for patients with recurrent varicocele. Materials and methods . The study included 254 patients with varicocele at the age of 34.8 ± 13.3 (16-44) years. Recurrent varicocele detected in 31 (12.8%) patients. May-Thurner syndrome was confirmed in 8 (3.15%) patients. In 40% of cases the syndrome of May-Thurner had identified at a recurrence to a varicocele Results. If you suspect a May-Thurner syndrome diagnostic algorithm appropriate to start with a search of the asymmetry of blood flow in the iliac veins according to Doppler ultrasound. Conclusion. The optimum therapeutic tactics in these patients will be intravascular stenting of the left iliac veins in identifying positive pressure gradient in it more than 10 mm Hg compared with the vena cava inferior.