Varicocele grading.

 

Clinical and ultrasonography grading of varicocele

Varicocele grading is done to provide a standardization in the diagnosis, treatment and follow-up of the disease.

Varicocele staging (grade) is done in two main ways:

1.     Grading system made clinically, namely by examination.

2.     Grading with scrotal color Doppler ultrasonography.

Clinical Grading of varicocele

Grade	Description
Grade 0	Seen on ultrasound, but not physically detectable (also called “subclinical varicocele”)
Grade I	Palpable (felt on exam) when the patient is performing the valsalva maneuver (“bearing down”)
Grade II	Palpable even without valsalva
Grade III	Varicocele causing visible deformity of the scrotum.

Ultrasonography Grading of varicocele

Starteschi classification (grade): Here, varicocele is divided into 5 stages according to the presence of reflux status and testicular atrophy.

Grade	Description
grade I	reflux at the level of groin only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade II	reflux at the level of the proximal segment of the pampiniform plexus only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade IV	reflux in the distal vessels at the level of lower scrotum only during the Valsalva maneuver, without scrotal deformation or testicular hypotrophy
grade V	resting reflux in the dilated pampiniform plexus, possibly increasing during the Valsalva maneuver, always accompanied by testicular hypotrophy

Return to list of medical grades (click here)

Ref:

Sarteschi L.M. Lo studio del varicocele con eco-color-Doppler. G Ital Ultrasonologia. 1993;4:43–49.