Morphological Changes in Varicocele Veins: Ultrastructural Study

Background: Varicocele consists of dilatation of the pampiniform venous plexus and the internal spermatic veins. It is present in 15% of male population and is a common cause of male infertility. Objective: To describe the normal structure of the internal spermatic vein and the morphological changes...

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Bibliographic Details
Published in:Ultrastructural pathology 2010-10, Vol.34 (5), p.260-268
Main Authors: Musalam, Adel Osman, Eid, Refaat A., Al-Assiri, Manae, Hussein, Mahmoud Rezk Abdelwahed
Format: Article
Language:English
Subjects:
electron microscopy
Humans
Male
Microscopy, Electron, Scanning
Microscopy, Electron, Transmission
spermatic vein
Tunica Intima - ultrastructure
Tunica Media - ultrastructure
varicocele
Varicocele - pathology
Veins - ultrastructure
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Summary:Background: Varicocele consists of dilatation of the pampiniform venous plexus and the internal spermatic veins. It is present in 15% of male population and is a common cause of male infertility. Objective: To describe the normal structure of the internal spermatic vein and the morphological changes in grade 3 varicocele. Methods: The authors dissected and analyzed a 2- to 3-cm tract of the pampiniform venous plexus of 20 patients undergoing varicocelectomy for left varicocele and of 10 consecutive patients undergoing surgery for left inguinal hernia. The histological examination was performed with hematoxylin-eosin and Masson trichrome stains. The ultrastructural evaluation was done using both scanning and transmission electron microscopy. Results: Compared with normal internal spermatic veins, varicocele veins showed narrowing and/or obliteration of the lumens, destruction of the endothelial cells, invagination of the intima, and deposition of collagen bundles in the media (light microscopy). The ultrastructural changes in varicocele veins included elongation of the endothelial cells with features of cellular damage, loss of the internal elastic lamina, and the appearance of ghost bodies and degenerative vacuoles in the subendothelial layer. Conclusions: The authors believe this is the first report analyzing ultrastructual changes in normal human internal spermatic vein samples and in varicocele. The underlying molecular mechanisms of these changes await further studies.
ISSN:0191-3123
1521-0758
DOI:10.3109/01913121003793067