Volume 16, Issue 10 (October 2018)                   IJRM 2018, 16(10): 649-652 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shakeri S, Malekmakan L, Manaheji F, Tadayon T. Inter-observer agreement on varicoceles diagnosis among patients referred to Shiraz Namazi Hospital. IJRM 2018; 16 (10) :649-652
URL: http://ijrm.ir/article-1-1269-en.html
1- Shiraz Nephro-Urology Research Center, Department of Urology, Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran
2- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Khalili Street, Shiraz, Iran , malekl@sums.ac.ir
3- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Khalili Street, Shiraz, Iran
Abstract:   (2139 Views)
Background: Varicocele is the collection of dilated veins of pampiniform plexus which is the most common cause of infertility occurred in 35-40% of infertile men. Despite all the diagnostic tools exist for varicocele diagnosis; still, a physical examination is the first step.
Objective: This study was done to determine the inter-observer agreement on varicoceles diagnosis.
Materials and Methods: In this cross-sectional study, two expert examiners evaluated 93 men with infertility, scrotal pain, and enlarged scrotum for the presence of varicocele. The urologists examined patients independently in two separate rooms. The inter-observer agreement on varicocele grading analyzed by the Spearman Rho correlation coefficient.
Results: The grading of varicocele were similar in 34 (36.5%) and 59 (63.4%) cases in the left and right side, respectively with correlation coefficient of 0.65 (0.51-0.75) and 0.25 (0.04-0.43), respectively. It implies that inter-observer agreement was substantial for left varicocele assessment and moderate for right varicocele assessment.
Conclusion: Physical exam is the essential diagnostic tool for varicocele. As long as the observers educated with the same standard method the disagreements reduced to the negligible extent.
Full-Text [PDF 274 kb]   (630 Downloads) |   |   Full-Text (HTML)  (392 Views)  
Type of Study: Short Research Reports |

References
1. Beddy P, Geoghegan T, Browne RF, Torreggiani WC. Testicular varicoceles. Clin Radiol 2005; 60: 1248-1255. [DOI:10.1016/j.crad.2005.06.010]
2. Jarow, JP. Effects of varicocele on male fertility. Hum Reprod Update 2001. 7: 59-64. [DOI:10.1093/humupd/7.1.59]
3. Clarke, BG. Incidence of varicocele in normal men and among men of different ages. JAMA 1966; 198: 1121-1122. [DOI:10.1001/jama.1966.03110230137039]
4. Gat Y, Bachar GN, Zukerman Z, Belenky A, Gorenish M. Physical examination may miss the diagnosis of bilateral varicocele: a comparative study of 4 diagnostic modalities. J Urol 2004; 172: 1414-1417. [DOI:10.1097/01.ju.0000138540.57137.5f]
5. Trum JW, Gubler FM, Laan R, Van der Veen F. The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele. Hum Reprod 1996; 11: 1232-1235. [DOI:10.1093/oxfordjournals.humrep.a019362]
6. Dhabuwala CB, Hamid S, Moghissi KS. Clinical versus subclinical varicocele: improvement in fertility after varicocelectomy. Fertil Steril 1992; 57: 854-857. [DOI:10.1016/S0015-0282(16)54970-X]
7. Carlsen E, Andersen AG, Buchreitz L, Jorgensen N, Magnus O, Matulevicuus V, et al. Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size. Int J Androl 2000; 23: 248-253. [DOI:10.1046/j.1365-2605.2000.00240.x]
8. Hargreave TB, Liakatas J. Physical examination for varicocele. Br J Urol 1991; 67: 328. [DOI:10.1111/j.1464-410X.1991.tb15148.x]
9. World Health Organization. Comparison among different methods for the diagnosis of varicocele. World Health Organization. Fertil Steril 1985; 43: 575-582.
10. Petros JA, Andriole GL, Middleton WD, Picus DA. Correlation of testicular color Doppler ultrasonography, physical examination and venography in the detection of left varicoceles in men with infertility. J Urol 1991; 145: 785-788. [DOI:10.1016/S0022-5347(17)38451-3]
11. Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968; 70: 213-220. [DOI:10.1037/h0026256]
12. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174. [DOI:10.2307/2529310]
13. Santoro G, Romeo C. Morphological and surgical overview of adolescent testis affected by varicocele. Scientific World Journal 2013; 2013: 469413-469420. [DOI:10.1155/2013/469413]
14. Cornud F, Belin X, Amar E, Delafontaine D, Helenon O, Moreau JF. Varicocele: strategies in diagnosis and treatment. Eur Radiol 1999; 9: 536-545. [DOI:10.1007/s003300050706]
15. Belay RE, Huang GO, Shen JK, Ko EY. Diagnosis of clinical and subclinical varicocele: how has it evolved? Asian J Androl 2016; 18: 182-185. [DOI:10.4103/1008-682X.169991]
16. Carlsen E, Andersen AG, Buchreitz L, Jorgensen N, Magnus O, Matulevicuus V, et al. Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size. Int J Androl 2000; 23: 248-253. [DOI:10.1046/j.1365-2605.2000.00240.x]
17. Shakeri S, Malekmakan L, Afrasiabi A, Yazdani M, Shakeri A, Shakeri A. Intra-observer variation in physical examination of varicocele. Int J Current Res 2014; 6: 9239-9241.
18. Olsen LH. Inter-observer Variation in Assessment of Undescended Testis Analysis of Kappa Statistics as a Coefficient of Reliability. Br J Urol 1989; 64: 644-648. [DOI:10.1111/j.1464-410X.1989.tb05328.x]
19. Pierik FH, Dohler GR, van Muiswinkel JM, Vreeburg JT, Weber RF. Is routine scrotal ultrasound advantageous in infertile men? J Urol 1999; 162: 1618-1620. [DOI:10.1016/S0022-5347(05)68180-3]
20. Sorokin I, Welliver C, Elebyjian L, Feustel PJ, McCullough A. Interinstitutional variability in testicular volumes and varicocele presence by ultrasound: surprising discrepancies and implications for clinical decision making. Urology 2015; 85: 1079-1084. [DOI:10.1016/j.urology.2015.02.018]

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb