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Testicular Asymmetry and Adolescent Varicoceles Managed Expectantly

2009; Lippincott Williams & Wilkins; Volume: 183; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2009.10.028

1527-3792

Stephen A. Poon, Carl K. Gjertson, Miguel Ángel Mercado, Peter M. Raimondi, Kristin Kozakowski, Kenneth I. Glassberg,

Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities

No AccessJournal of UrologyPediatric Urology1 Feb 2010Testicular Asymmetry and Adolescent Varicoceles Managed Expectantly Stephen A. Poon, Carl K. Gjertson, Miguel A. Mercado, Peter M. Raimondi, Kristin A. Kozakowski, and Kenneth I. Glassberg Stephen A. PoonStephen A. Poon More articles by this author , Carl K. GjertsonCarl K. Gjertson Current address: Division of Urology, Department of Surgery, University of Connecticut Health Center, 263 Farmington Ave., Farmington, Connecticut 06030-3955. More articles by this author , Miguel A. MercadoMiguel A. Mercado More articles by this author , Peter M. RaimondiPeter M. Raimondi More articles by this author , Kristin A. KozakowskiKristin A. Kozakowski Current address: Division of Urology, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. More articles by this author , and Kenneth I. GlassbergKenneth I. Glassberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.10.028AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Adolescent varicocele is often associated with testicular asymmetry. Depending on the degree of asymmetry, some physicians will recommend surgery. However, given the possibility that asynchronous growth may be transient, others advocate for a period of observation. We reviewed our outcomes in such patients who were initially treated expectantly. Materials and Methods: We retrospectively reviewed our pediatric varicocele database. We analyzed the outcomes of patients presenting for evaluation of varicocele who were followed with serial testicular volume measurements using scrotal ultrasound or ring orchidometry and who had at least a 6-month interval between measurements. Fisher's exact test was used to compare groups based on initial and final testicular asymmetry. Results: We identified 181 patients (median age 13.8 years) who were followed expectantly. Serial volume measurements had been obtained at a median interval of 12 months (interquartile range 8 to 21) between first and most recent visits. Mean percent asymmetry for the group did not change with time. Among patients who initially had less than 20% asymmetry 35% had 20% or greater asymmetry on followup, and among those with 20% or greater asymmetry initially 53% remained in that range (p = 0.007). Conclusions: Asymmetry can be a transient phenomenon. Patients with initial asymmetry can end up with significant asymmetry, and many with significant asymmetry can have catch-up growth. However, when patients have a peak retrograde flow of 38 cm per second or greater on duplex Doppler ultrasound in association with 20% or greater asymmetry spontaneous catch-up growth is unlikely to occur. 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Google Scholar Division of Pediatric Urology, Morgan Stanley Children's Hospital of New York–Presbyterian and Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York© 2010 by American Urological AssociationFiguresReferencesRelatedDetailsCited byKolon T, Glassberg K and Van Batavia J (2018) Varicocele: Early Surgery versus ObservationJournal of Urology, VOL. 192, NO. 3, (645-647), Online publication date: 1-Sep-2014.Van Batavia J, Badalato G, Fast A and Glassberg K (2018) Adolescent Varicocele—Is the 20/38 Harbinger a Durable Predictor of Testicular Asymmetry?Journal of Urology, VOL. 189, NO. 5, (1897-1902), Online publication date: 1-May-2013.Korets R, Woldu S, Nees S, Spencer B and Glassberg K (2011) Testicular Symmetry and Adolescent Varicocele—Does it Need Followup?Journal of Urology, VOL. 186, NO. 4S, (1614-1619), Online publication date: 1-Oct-2011.Van Batavia J, Woldu S, Raimondi P, Spencer B, Insel B, Poon S and Glassberg K (2010) Adolescent Varicocele: Influence of Tanner Stage at Presentation on the Presence, Development, Worsening and/or Improvement of Testicular Hypotrophy Without Surgical InterventionJournal of Urology, VOL. 184, NO. 4S, (1727-1732), Online publication date: 1-Oct-2010. Volume 183Issue 2February 2010Page: 731-734 Advertisement Copyright & Permissions© 2010 by American Urological AssociationKeywordstestisvaricoceleadolescentultrasonographyMetricsAuthor Information Stephen A. Poon More articles by this author Carl K. Gjertson Current address: Division of Urology, Department of Surgery, University of Connecticut Health Center, 263 Farmington Ave., Farmington, Connecticut 06030-3955. More articles by this author Miguel A. Mercado More articles by this author Peter M. Raimondi More articles by this author Kristin A. Kozakowski Current address: Division of Urology, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. More articles by this author Kenneth I. Glassberg More articles by this author Expand All Advertisement PDF downloadLoading ...