ULTRASOUND FEATURES

Ultrasound gradings

Sarteschi grading for Varicocele

GRADE I: No dilated veins anywhere. Only reflux in spermatic cord veins of inguinal region on valsalva

GRADE II: Dilated supratesticular veins with reflux on valsalva

GRADE III: Findings only on standing: Dilated veins upto lower pole with reflux on valsalva

GRADE IV: Dilated veins in both supine and standing increasing in caliber on valsalva. Reflux at rest increasing on valsalva. Testicular hypotrophy may be present

GRADE V: Same as IV. No increase in calibre and reflux on valsalva. Intratesticular varices may be present.

Pampiniform plexus veins are considered dilated when calibre is > 3mm. Reflux is assessed on color doppler and considered pathological if > 2 seconds in duration. Transient reflux < 1.5 seconds is normal.