Examination of testicular veins in children with varicocele

BACKGROUND: Diagnostics and management of varicocele in children, adolescents and males are issues of annual discussions in the professional community, yet the debates still continue. Pathophysiological changes in the testicular veins in children with varicocele are dubious and require further in-depth fundamental researches. AIM: To study the difference in ultrastructural organization of testicular veins in boys with varicocele depending on the malformation degree. METHODS: In the present study, the authors examined the ultrastructure of 58 bioptats taken from spermatic veins during surgeries in adolescent boys aged 11–17 with varicocele of degree II and III. RESULTS: A comparative analysis of ultrastructural changes in the spermatic veins revealed that signs of endotheliocyte destruction of varying degree are met in 86% of biopsy samples in Group I and in 100% in Group II. Electron microscopy allowed to examine the muscular component of testicular veins in varicocele, as well as to examine the structure of connective tissue component in the venous wall, basing on an anatomical-functional paradigm of the connective tissue as the main "building brick" of organ and system structures. CONCLUSION: Ultrastructural changes in the testicular vein wall were revealed in children with varicocele, what indicates the presence of congenital malformation in this wall and of accompanied endothelial dysfunction. Foldings of the vascular wall with hollows and pockets, connective tissue loosening and separation of fibers, endothelium destruction and detachment were equally met in boys and adolescents with varicocele of degree II and III.