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Valsalva Maneuver in Scrotal Ultrasound
Purpose:
The Valsalva maneuver is a breathing technique used during a scrotal ultrasound to assess varicocele, which is a dilation of the pampiniform plexus veins. This maneuver increases intra-abdominal pressure, which helps identify venous reflux and distension of the veins.
How to Perform the Valsalva Maneuver:
- Ask the patient to take a deep breath.
- Instruct them to bear down (as if straining during a bowel movement) and hold their breath for a few seconds.
- Observe the pampiniform plexus veins using color Doppler ultrasound.
- Release the strain and assess the changes in venous flow.
Ultrasound Findings:
- Normal Veins: Should not significantly dilate or show reflux.
- Varicocele (Abnormal Finding):
- Veins dilate > 2–3 mm in diameter.
- Increased blood flow on color Doppler, especially with reflux during the maneuver.
- Often seen more on the left side due to venous drainage anatomy.
When to Use the Valsalva Maneuver in Scrotal Ultrasound:
➤ Evaluating Varicocele (Primary & Secondary)
➤ Assessing Venous Reflux
➤ Confirming Mild or Subclinical Varicocele
➤ Before and After Treatment Follow-up
