Arteryovenous conflicts in men with urological pathology

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Abstract

For the present study, we analyzed previously known and current data on arteriovenous conflicts in men from the perspective of urologists and andrologists. The least studied and controversial decision-making position was for iliac venous compression and pelvic varicose veins in men. The data testify to the need to revise the traditional and generally accepted positions for managing varicocele.

About the authors

Alexandr A. Kapto

Peoples’ Friendship University of Russia of Ministry of Education and Science of the Russian Federation

Author for correspondence.
Email: alexander_kapto@mail.ru

Candidate of Medical Science, Associate Professor, Department of Clinical Andrology, Faculty of Professional Development of Medical Workers of Medical Institute

Russian Federation, Moscow

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2. Fig. 1. Syndrome of the superior mesenteric artery. Front view: compression of the duodenum by the superior mesenteric artery (left), view in the sagittal projection - norm (in the middle), view in the sagittal projection - compression of the duodenum by the superior mesenteric artery (right)

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3. Fig. 2. Nutcracker syndrome. The arrow indicates the place of aortosferential compression of the left renal vein

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4. Fig. 3. Types of retro-aortic left renal vein by J.K. Nam et al. (2010) [19]: type 1 - horizontal; type 2 - oblique, flowing into the lower vena cava at level L4-5; type 3 - annular; type 4 - anastomosing with the left common iliac vein

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5. Fig. 4. Transposition of the left renal vein: a - aortosferential compression of the left renal vein; b - transposition of the left renal vein with the intersection and ligation of the left adrenal and left ovarian veins

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6. Fig. 5. Normal view of the left common iliac vein in the anterior-posterior and lateral views of the W.E. Ehrich, E.B. Krumbhaar (1943) [37]

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7. Fig. 6. Various types of obstruction of the left common iliac vein in the anterior-posterior and lateral projections according to W.E. Ehrich, E.B. Krumbhaar (1943) [37]

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8. Fig. 7. The compression of the left common iliac vein with the right common iliac artery to the body of the 5th vertebra (Mei-Turner syndrome)

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9. Fig. 8. Variants of non-intramural iliac venous compression (nonthrombotic iliac vein lesion, NIVL), S. Raju and P. Neglen (2006) [43]

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10. Fig. 9. Classification of vascular anomalies at the site of crossing the right common iliac artery by H. Mitsuoka et al. (2013) [44]: A - abdominal aorta; V - inferior vena cava; RA - right common iliac artery; LA - left common iliac artery; RV - right common iliac vein; LV - left common iliac vein

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11. Fig. 10. Moorings (synechiae, adhesions) in the lumen of the left common iliac vein [44]

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12. Fig. 11. Prevalence of adhesions in the lumen of veins according to H. Mitsuoka et al. (2014) [44]. Group A - complete or partial compression of the right common iliac artery of the left common iliac vein (aortic bifurcation at the lower level); group B - the right common iliac artery compresses the lower vena cava (aortic bifurcation at a high level)

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13. Fig. 12. Classification of morphological changes of the left common iliac vein in the Mei-Türner syndrome according to U.B. Jeon et al. (2010): type 1 - focal compression of the right common iliac artery; type 2 - diffuse atrophy of the left common iliac vein; type 3 - cicatricial obliteration of the left common iliac vein

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14. Fig. 13. Endovascular treatment of compression syndrome of the left common iliac vein: 1 - perioperative phlebography; 2 - balloon venoplasty; 3 - stent installation in the left common iliac vein; 4 - control phlebography

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15. Fig. 14. V.F. Harpunov, R.E. Mamedov, A.A. Capto. City Clinical Hospital. E.O. Mukhina. The first balloon angioplasty and stenting of the left common iliac and left external iliac veins to a man with Mei-Tyurner syndrome and varicose veins of the pelvic organs

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16. Fig. 15. Classification of varicocele according to B.L. Coolsaet (1980) [53]: I - the renospermatic type; II - ileospermatic type; III - mixed type

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17. Fig. 16. Venous outflow from the testicle with various hemodynamic varicocele types according to AA. Kapto (2016) [55]

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18. Fig. 17. Retrograde renal phlebotestuculography. Contrasting the paraprostatic venous plexus on the side of the varicocele. On the left, discharge through the internal iliac vein predominates. In the middle and on the right, the discharge through the vein of the vas deferens predominates

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19. Fig. 18. TRUSI prostate gland in patients with left-sided (left) and bilateral varicocele (right). There is varicose veins of the paraprostatic venous plexus on the side of the localization of varicocele

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20. Fig. 19. Two parallel pathogenetic mechanisms in patients with varicocele

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Copyright (c) 2018 Kapto A.A.

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