Scrotal infrared digital thermography in varicocele — Additional analysis

Varicocele is dilatation of pampiniform venous plexus. The incidence of varicocele is about 15% in male population. The main pathophysiological mechanism for impaired spermatogenesis is considered to be elevated scrotal temperature. Mainstay for diagnostic assessment of varicocele is physical examination and scrotal ultrasound/doppler. Thermography is a diagnostic method which measures temperature differences across the skin surface using a highly sensitive infrared camera. Aim of this study is to further analyse our diagnostic criteria for scrotal thermography in diagnosing varicocele in student population. Study group consisted of 55 patients of mean age 20.2±1.2 who are first or second year students. All patients were evaluated by three methods. Infrared digital thermography was followed by physical examination and ultrasound/doppler. Infrared camera Thermo Tracer TH7102WL (NEC Sanei Instruments, Ltd., Japan) was used during all measurements. This infrared system has a geometric resolution of 76.800 pixels per picture (320×240) and the minimum detectable temperature resolution (difference) is 0.07° C at 30°C (Normal mode). At physical examination 16 patients had varicocele. Scrotal thermography was positive of varicocele in 19 patients. In 16 patients it was positive of left sided varicocele and in three of bilateral varicocele. Comparative analysis confirmed varicocele at physical examination and scrotal thermography in 13 patients. Physical examination missed diagnosis in six patients while scrotal thermography failed to confirm varicocele in three patients with positive physical examination. In patients with left sided varicocele at scrotal thermography mean temperature at left pampiniform plexus was 34.1±0.6°C and at right pampiniform plexus 33.0±0.4°C. Temperature at left testicle was 33.3±0.7°C while at right testicle it was 32.9±0.7°C. Temperature difference between left and right pampiniform plexus in patients with positive left sided scrotal thermography was 1.1±0.7°C while in patients with negative scrotal thermography it was 0.4±0.7°C. Scrotal infrared digital thermography presents diagnostic method with possibly high sensitivity and specificity for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate this method as well as its applicability in postoperative settings.