Is ultrasonography better because venography is subject to technical variations?
Venography shows, in real time, the direction of blood flow in the spermatic veins. Using manual injections with a tilt table, one can demonstrate the residual traces of incompetent or destroyed valves, partially or intermittently competent valves, and the collaterals and venous bypasses associated with the varicocele. The ideal treatment modality is to allow the clinician to obtain the most detailed anatomic, physiological and pathophysiological information possible before and while performing interventional treatment. The imaging achieved with ultrasonography may provide certain additional dimensions of information about blood flow in the testis, but cannot address the anatomy of the retroperitoneal ISV system. More important to our discussion of right sided reflux is the fact that because back-flow cannot be produced by the Valsalva maneouvre, ultrasonography cannot detect reflux easily on the right side. Imaging of the colour flow Doppler is based on minimal resolution threshold of
