Testicular Asymmetry and Adolescent Varicoceles Managed Expectantly

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

doi:10.1016/j.juro.2009.10.028

Cited by 42 publications

(26 citation statements)

References 10 publications

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“…A study by Poon et al illustrates these possibilities [10]. The authors reviewed asymmetry data, compiled using both ultrasound and orchidometer, of 181 patients followed for a median of 12 months.…”

Section: Discussionmentioning

confidence: 99%

Natural history of testicular size in boys with varicoceles

Khasnavis

Kogan²

2015

Journal of Pediatric Urology

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Section: Discussionmentioning

confidence: 99%

Natural history of testicular size in boys with varicoceles

Khasnavis

Kogan²

2015

Journal of Pediatric Urology

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“…The evaluation of testicular function in children is committed to testicular volume only, detected with US. From this point of view, several studies investigated the role of testicular volume in pre‐operative management of varicocoele with different results (Poon et al. , 2010; Spinelli et al.…”

Section: Discussionmentioning

confidence: 99%

Focus on paediatric and adolescent varicocoele: a single institution experience

et al. 2012

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The aim of this study was to report our long-term diagnostic and surgical outcome during the last 18 years, in paediatric and adolescent management of varicocoele. The present retrospective study enrols 374 patients observed at our institution between 1994 and 2011. Patients were divided into three groups: Group A includes 142 youngsters and adolescents treated with open surgery for left varicocoele, in which a pre-operative CDUS was not performed; Group B includes 65 patients treated with open surgery in which a pre-operative CDUS evaluation was carried out, to assess varicocoele haemodynamic pattern and testicular volume. Group C includes 167 patients treated by laparoscopy and with pre-operative CDUS assessment. For all groups post-operative follow-up consisted of CDUS evaluation performed 1, 3, 6, 12 months after surgical treatment, than every year. Persistence/recurrence of varicocoele, testicular volume and presence of hydrocele were evaluated. Recurrence rate was significatively higher in group A (11.2%) than B (no recurrence, p = 0.003) or C (no recurrence, p = 0.000). Post-operative hydrocele was not significantly observed overall in group A in 9.8% of cases (13% if tunica vaginalis was left untouched, 4.2% if everted or resected p = 0.005), in group B in 3% and in group C in 7.1% of cases (p = NS). In conclusion, open and laparoscopic surgery offers similar results. In our opinion, the key-point in paediatric and adolescent varicocoele is not the surgical approach to use, but the exact diagnosis. Careful CDUS evaluation is, in our opinion, a valid, safe, cost-effective and immediate tool to accurately detect all refluxing venous system and for achieving a comprehensive evaluation of the vascular anatomy of varicocoele in paediatric and adolescent age. Laparoscopic Palomo or open subinguinal microsurgical varicocelectomy offer similar results in terms of recurrence; meanwhile the use of a lymphatic sparing surgery with or without blue-dye is recommended to reduce post-operative hydroceles.

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“…27 Poon et al had similar findings in a retrospective review involving 181 patients. 28 In patients with a PRF between 30 cm/second and 38 cm/second, data from various series show increased risk for developing progressive testicular asymmetry even when initial testicular asymmetry was less than 15%. 27,29,30 Measurement of the maximum vein diameter (MVD) of the pampiniform plexus during Valsalva in adults is a prognosticator for semen parameters following varicocele repair, with an MVD greater than 3 mm preoperatively associated with favourable outcomes.…”

Section: Sonographic Parametersmentioning

confidence: 98%

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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Testicular Asymmetry and Adolescent Varicoceles Managed Expectantly

Cited by 42 publications

References 10 publications

Natural history of testicular size in boys with varicoceles

Natural history of testicular size in boys with varicoceles

Focus on paediatric and adolescent varicocoele: a single institution experience

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

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