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Testicular Growth Arrest and Adolescent Varicocele: Does Varicocele Size Make a Difference?

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 4 Part 2 Linguagem: Inglês

10.1016/s0022-5347(05)64389-3

1527-3792

John C. Thomas, Jack S. Elder,

Sexual Differentiation and Disorders

No AccessJournal of UrologyTestis Tumors, Cryptorchidism, Varicocele1 Oct 2002Testicular Growth Arrest and Adolescent Varicocele: Does Varicocele Size Make a Difference? John C. Thomas and Jack S. Elder John C. ThomasJohn C. Thomas and Jack S. ElderJack S. Elder View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64389-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed whether testicular growth arrest is related to varicocele size in adolescents. We also determined whether adolescents with a varicocele and testes of equal size treated nonoperatively are at significant risk for growth arrest and, if so, whether this risk is related to varicocele size. Materials and Methods: We retrospectively reviewed the records of boys with a varicocele. Testis volume was measured with calipers and computed into cc as (length × width × breadth) × 0.521. Testicular growth arrest was defined as left testis at least 15% smaller than the right testis. Varicocele size was graded 1—barely palpable, 2—palpable but not visible, 3a—visible and, 1 to 1.5 times the size of the ipsilateral testis, 3b—1.5 to 2 times the size of the ipsilateral testis and 3c—greater than 2 times the size of the ipsilateral testis. Boys with a grade 1 varicocele and those treated with previous inguinal or testicular surgery were excluded from study. Repair was recommended for testicular growth arrest or discomfort. Data were analyzed with chi-square and Fisher's exact test. Results: The records of 124 boys 7 to 18 years old (mean age 13) with a varicocele were reviewed. Seven patients were excluded from analysis, yielding a total of 117 boys. Testicular growth arrest was observed at initial visit in 10 of 33 (30.3%) grade 2, 18 of 37 (48.6%) grade 3a, 14 of 31 (45.2%) grade 3b and 6 of 16 (37.5%) grade 3c cases (p not significant), or a total of 38 of 84 (45.2%) grade 3 cases (p <0.01) plus grade 2. Followup ranged from 1 to 5 years. Of the cases of equal sized testes at presentation growth arrest was observed in 3 of 16 (18.8%) grade 2, 2 of 11 (18.2%) grade 3a, 4 of 14 (28.6%) grade 3b and 3 of 9 (33.3%) grade 3c (p not significant), or a total of 9 of 34 (26.5%) grade 3 cases (p not significant) plus grade 2. Overall, testicular growth arrest was found in 13 of 33 (39%) grade 2 and 47 of 84 (56%) grade 3 varicoceles (p <0.01). Conclusions: Boys with a varicocele are at significant risk for testicular growth arrest, irrespective of varicocele size, and those with a grade 3 varicocele have a higher risk of testicular growth arrest than those with a grade 2 varicocele. Of boys with testes of equal size at diagnosis growth arrest is observed during adolescence in approximately 25% irrespective of varicocele size. References 1 : The adolescent varicocele: what's new with an old problem in young patients. Pediatrics1997; 100: 112. Google Scholar 2 : The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int2000; 86: 490. Google Scholar 3 : Varicoceles: effect on testicular volume in prepubertal and pubertal males. Urology1993; 41: 466. Google Scholar 4 : Reversal of testicular growth failure by varicocele ligation. J Urol1987; 137: 475. Link, Google Scholar 5 : Prevention of fertility disorders by detection and treatment of varicocele at school and college age. Andrologia1976; 8: 47. Google Scholar 6 : Clinical measurements of the testes in boys and men. Acta Med Scand1951; 142: 457. Google Scholar 7 : Repair versus observation in adolescent varicocele: a prospective study. J Urol1997; 158: 1128. Link, Google Scholar 8 : Progressive atrophy in the varicocele patient. J Urol1977; 117: 175. Link, Google Scholar 9 : Loss of fertility in men with varicocele. Fertil Steril1993; 59: 613. Crossref, Medline, Google Scholar 10 : Varicocele in adolescence induces left and right testicular volume loss. BJU Int2001; 87: 499. Google Scholar 11 : Varicocele. Urol Clin North Am1987; 14: 499. Crossref, Medline, Google Scholar 12 : Surgical repair of varicocele at puberty: preventative treatment for fertility improvement. J Urol1988; 139: 562. Link, Google Scholar 13 : Testicular histology in the adolescent with a varicocele. Pediatrics1987; 79: 996. Google Scholar 14 : Effects of varicocele treatment in adolescents: a randomized study. Fertil Steril1992; 58: 756. Google Scholar 15 : Left varicocele at puberty. Urology1983; 22: 271. Google Scholar 16 : Testicular volume assessment in the adolescent with a varicocele. J Urol1992; 147: 1348. Link, Google Scholar 17 : Comparative assessment of pediatric testicular volume: orchidometer versus ultrasound. J Urol2000; 164: 1111. Link, Google Scholar 18 : Current management of adolescent varicocele. Rev Urol2001; 3: 120. Google Scholar 19 : Varicocele treatment in pubertal boys prevents testicular growth arrest. J Urol1997; 157: 1456. Link, Google Scholar 20 : Prepubertal varicoceles. Urology1997; 50: 774. Google Scholar From the Division of Pediatric Urology, Rainbow Babies and Children's Hospital, Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKolon T (2015) Evaluation and Management of the Adolescent VaricoceleJournal of Urology, VOL. 194, NO. 5, (1194-1201), Online publication date: 1-Nov-2015.Christman M, Zderic S, Canning D and Kolon T (2013) Active Surveillance of the Adolescent with Varicocele: Predicting Semen Outcomes from UltrasoundJournal of Urology, VOL. 191, NO. 5, (1401-1406), Online publication date: 1-May-2014.Christman M, Zderic S and Kolon T (2013) Comparison of Semen Analyses in Youths with a History of Cryptorchidism or VaricoceleJournal of Urology, VOL. 190, NO. 4S, (1561-1565), Online publication date: 1-Oct-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.Spinelli C, Di Giacomo M, Lo Piccolo R, Martin A and Messineo A (2010) The Role of Testicular Volume in Adolescents With Varicocele: The Better Way and Time of Surgical TreatmentJournal of Urology, VOL. 184, NO. 4S, (1722-1726), Online publication date: 1-Oct-2010.Walker A and Kogan B (2010) Cost-Benefit Analysis of Scrotal Ultrasound in Treatment of Adolescents With VaricoceleJournal of Urology, VOL. 183, NO. 5, (2008-2011), Online publication date: 1-May-2010.Kozakowski K, Gjertson C, Decastro G, Poon S, Gasalberti A and Glassberg K (2009) Peak Retrograde Flow: A Novel Predictor of Persistent, Progressive and New Onset Asymmetry in Adolescent VaricoceleJournal of Urology, VOL. 181, NO. 6, (2717-2723), Online publication date: 1-Jun-2009.Kolon T, Clement M, Cartwright L, Bellah R, Carr M, Canning D and Snyder H (2008) Transient Asynchronous Testicular Growth in Adolescent Males With a VaricoceleJournal of Urology, VOL. 180, NO. 3, (1111-1115), Online publication date: 1-Sep-2008.ALUKAL J, ZURAKOWSKI D, ATALA A, BAUER S, BORER J, CILENTO B, MANDELL J, PETERS C, PALTIEL H, RETIK A and DIAMOND D (2018) TESTICULAR HYPOTROPHY DOES NOT CORRELATE WITH GRADE OF ADOLESCENT VARICOCELEJournal of Urology, VOL. 174, NO. 6, (2367-2370), Online publication date: 1-Dec-2005. Volume 168Issue 4 Part 2October 2002Page: 1689-1691 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.KeywordsgrowthvaricoceletestisadolescenceMetricsAuthor Information John C. Thomas More articles by this author Jack S. Elder More articles by this author Expand All Advertisement PDF downloadLoading ...