Association Between Physical Examination, Doppler Ultrasound, and Histological Findings and Varicocele Diagnosis in Kidney Donors: A Cross-Sectional Study

Background: Varicocele is a leading cause of male infertility. Left-sided nephrectomy has been associated with an increased risk of varicocele. Objectives: This study aimed to report the frequency and investigate the association between physical examination, Doppler ultrasonography, histological findings, and varicocele diagnosis in kidney donors who underwent left-sided nephrectomy. Methods: This cross-sectional study included adult males who underwent nephrectomy. The study compared the results of physical examination, ultrasound, and histological findings of the diameter of the left spermatic vein and pampiniform venous plexus. The chi-square test was used to assess differences in the diagnosis and grading of varicocele between the different methods. Results: Fifty males with a mean age of 36.6 years were included. Through physical examination, 42% were diagnosed with varicocele, with most cases classified as grade II. Ultrasound examination revealed that 46% had varicocele, with the majority also being grade II. Histological findings showed that most cases had intact valves (54%), followed by lax and incompetent valves (32%), and no valves (4%). There was a significant difference between the physical examination diagnosis of varicocele and the histological findings (P = 0.04), whereas the difference was not significant for Doppler ultrasound (P = 0.07). Conclusions: In kidney donors, there was a notable discrepancy in varicocele diagnosis between physical examination and histological findings, unlike ultrasound. Larger observational studies are recommended to further assess this association and explore alternative methods for varicocele diagnosis.