Clinical manifestations of undifferentiated connective dysplasia disease as predictors of varicocele

Introduction. Undifferentiated connective tissue disease (UCTD) is genetically-determined systemic process. First clinical manifestations occur in childhood or adolescence. Varicocele is an example of varicose veins transformation and represents one of most significant “minor criterion” of the UCTD. Aim. To determine a correlation between presence of typical features of UCTD and varicocele or varicose vein dilatation of other locations. Materials and methods. Clinical data and biopsy results of 70 patients aged 3-44 years (children, adolescents and adults) were analyzed. All patients were divided into three groups. In main group, there were patients with left-side varicocele, while control group 1 included patients with varicose veins of lower extremities and control group 2 consisted of male with combined symptomatic hemorrhoids. Histological examination of vein walls and/or excised hemorrhoidal nodes was performed in all cases. In addition, patients were interviewed using the survey “Diagnostic coefficient and informative coefficient of connective tissue dysplasia”, developed up by T.I. Kadurina, which included 39 phenotypic sings. Results. The majority of all patients (58.57%) had more than 5 sings of UCTD. In 10 boys and adolescents with varicocele and 9 out of10 children with varicose veins of lower extremities, five and more sings of UCTD were revealed. Adult patients had fewer number of UCTD sings, which suggest genetic predisposition of UCTD. Most common and significant signs which were found in all groups, included pes planus, long second-toe syndrome, scoliosis of 1-2 stage, joint hypermobility. Conclusion. In our opinion, it is advisable to conduct a survey in children and young patients with preclinical stage of the varicocele, especially in boys with varicocele in the first-degree relatives, in order to identify signs of UCTD and ensure an individualized treatment approach.

predictors of varicocele, undifferentiated connective tissue dysplasia, varicose veins, hemorrhoids