Diagnosis, Evaluation and Treatment of Adolescent Varicocele

Paduch, Darius A.; Skoog, Steven J.

doi:10.1100/tsw.2004.76

Cited by 16 publications

(14 citation statements)

References 133 publications

(123 reference statements)

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“…Steeno et al [2] found that a number of psychological reactions (anxiety and depressed mood) were experienced in B30% of boys who were informed about varicocele. As the word 'infertility' is often associated with sexual impairment, Paduch et al [49] believe that during discussion with the patient and his parents, the only fact that should be stressed is that the varicocele may result in a decrease in testicular volume and can be reversed with surgical treatment. They stated that it is hard to discount the association between varicocele and infertility in this era of common accessibility to the medical literature on the Internet.…”

Section: What To Do?mentioning

confidence: 98%

A challenging ‘bag of worms’

Younis¹,

Hamed²

2015

Human Andrology

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About 4.6-16.2% of male adolescents may be affected by varicocele. The most important damaging effect of varicocele in adolescents is testicular growth arrest (hypotrophy). Ultrasound is more accurate compared with orchidometry in detecting hypotrophy. Histopathologically, the testis of adolescent boys affected by varicocele shows Leydig cell hyperplasia, decreased number of spermatogonia per tubule, spermatogenesis arrest, and sloughing of the germinal epithelium. Varicocele in adolescents negatively affects sperm density and motility, and this seems to be related to testicular volume. To treat or not to treat adolescent varicocele is a controversial question. This is due to conflicting reports about the effectiveness of varicocelectomy. On one hand, some studies demonstrated a significant catch-up growth of the testis but found that prophylactic varicocele repair might expose many individuals to the unnecessary risks of surgery. Furthermore, this catch up of testicular volume could be due to edema secondary to severing of lymphatics during the procedure. On the other hand, other studies found that varicocele correction in adolescents not only improved testicular hypotrophy but also improved semen quality. Complications of varicocelectomy, such as recurrence or hydrocele incidence, are less common in open varicocelectomy than in laparoscopic or percutaneous embolization when treating varicocele in adolescents.

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Section: What To Do?mentioning

confidence: 98%

A challenging ‘bag of worms’

Younis¹,

Hamed²

2015

Human Andrology

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“…It was initially postulated there is a difference in hydrostatic pressure between the left and right side accounting for the differences in varicocele formation. 6 In particular, the differences in length of the left and right veins and the potential compression of the left testicular vein by the superior mesenteric artery and aorta in what is known as the "nutcracker effect" may lead to increased venous pressure on the left side. 7 Varicoceles are significantly more common in adolescents than in children; it is also postulated that the increased arterial blood flow to the testes at puberty exceeds the venous capacity, resulting in pampiniform venous plexus dilatation.…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

Varicoceles in the pediatric population: Diagnosis, treatment, and outcomes

Reyes¹,

Locke²,

Afshar³

2017

CUAJ

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Varicocele is commonly encountered in adolescents. There are still many controversies regarding pathophysiology, health effects, clinical significance, and optimum treatment of this condition. This article reviews the current evidence pertaining to children and adolescents with varicocele. This group present a unique and somehow challenging situation, since they are still going through pubertal changes that may confound the effects of the disease and its treatment on the developing testes.

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“…Unfortunately semen analysis is mostly impractical in adolescent population and no established norms exist for adolescent semen analysis [1, 3, 48]. …”

Section: Microscopic Investigation (Figure 2)mentioning

confidence: 99%

Morphological and Surgical Overview of Adolescent Testis Affected by Varicocele

Santoro

Romeo

2013

The Scientific World Journal

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Varicocele is a common pathology of the testis frequently associated with infertility. For its management, a fine morphological study of the testis, both macroscopically and microscopically, and an accurate choice of surgical procedure are mandatory. The present review focuses its attention on the anatomic substrates of adolescent varicocele and its pathophysiologic modifications. The comprehensive assessment of all the reported alterations should be considered by the clinician before deciding the type of treatment and the timing.

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Diagnosis, Evaluation and Treatment of Adolescent Varicocele

Cited by 16 publications

References 133 publications

A challenging ‘bag of worms’

A challenging ‘bag of worms’

Varicoceles in the pediatric population: Diagnosis, treatment, and outcomes

Morphological and Surgical Overview of Adolescent Testis Affected by Varicocele

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