Blood flow condition in the left renal vein in operative treatment of patients with varicocele

The purpose of the study was to evaluate the blood flow in the left renal vein after ligation of the internal spermatic vein with varicocele and to study the changing of the level of biological markers of acute kidney damage in these patients. Materials and methods. Under observation were 64 men in age 18–23 years with the first hemodynamic type of varicocele. In 3 patients clinically significant compression of the left renal vein was revealed and the remaining 61 patients underwent surgery by Ivanissevich approach. Before the operation, on the 2 nd , 10 th , 30 th and 90 th days after the operation patients underwent Doppler blood flow rate by ultrasound with color mapping of the left renal vein with measurement of venous blood flow velocity. During these periods all patients underwent laboratory tests, including the study of the content of cystatin C and interleukin 18 in the blood and urine. Results. On the first day after ligation of the internal spermatic vein an increase in the concentration of biological markers of acute kidney damage in the blood and urine was noted. After surgery all patients showed an increase in the diameter of the left renal vein by 1.5–2 mm and a decrease in the linear blood flow velocity in the region of the renal vien by 5–6 cm/s. On the 10th day after the operation the diameter of the left renal vein was increasesd by 3–4 mm more and the linear blood flow velocity slows down by 2–2.5 cm/s. The restoration of blood flow velocity and the diameter of the left renal vein occurred within three months and in most cases returned to baseline and in 22.9% of patients recovery did not occur by the 90 th day of observation. Conclusion. Ligation of the internal spermatic vein with varicocele is accompanied by impaired blood flow in the left renal vein and an increase in the concentration of biological markers of acute kidney damage, which is a manifestation of venous hypertension and renal hypoxia. In most patients these indicators normalize to the 90 th day of observation after surgery.