Varicocele in Adolescents: A 6-Year Longitudinal and Followup Observational Study

Zampieri, Nicola; Cervellione, Raimondo M.

doi:10.1016/j.juro.2008.03.114

Cited by 71 publications

(54 citation statements)

References 15 publications

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“…30 One study has focused specifically on the correlation between hemodynamic grade and pubertal development, testicular vein reflux, and semen quality in adolescent patients. 36 All patients who developed hypotrophy and testicular asymmetry during followup in this study had spontaneous venous reflux on CDUS that was classified as high hemodynamic grade.…”

Section: Hemodynamic Grading Systemsmentioning

confidence: 90%

The hemodynamic approach to evaluating adolescent varicocele

et al. 2012

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| During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack of spontaneous improvement in adolescent patients with ≥20% asymmetry between testes. CDUS also enables the detection of varicocele resulting from reflux in the deferential vein adjunctive to a refluxing internal spermatic vein; a causality that accounts for approximately 15% of cases. In addition to a diagnostic role, hemodynamic parameters can be used to predict the risk of persistence or worsening asymmetry. Although further studies are necessary to validate single parameters, it seems that the more severe the reflux, the greater the likelihood that the patient will develop testicular asymmetry.

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Section: Hemodynamic Grading Systemsmentioning

confidence: 90%

The hemodynamic approach to evaluating adolescent varicocele

et al. 2012

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“…[17][18][19] Since for postoperative evaluation in pediatric age, semen analysis cannot be performed, testicular catch-up volume is the most important parameter in evaluating the outcome of varicocelectomy. [9] Some investigators have reported recovery of testicular development, and sperm dysfunction after varicocelectomy. [10,20,21] Sinanoğlu et al [10] followed up 39 adolescents with varicocele at 3 month-intervals after varicocelectomy just by calculating testicular volumes.…”

Section: Discussionmentioning

confidence: 99%

“…[8] As an accepted strategy in adolescent varicocele treatment should be instituted in case of ipsilateral testicular hypotrophy. [7,9] In these patients, indications for surgical intervention are debatable, more than 20% difference in testicular size relative to the intact testis, abnormalities in sperm parametres, and painful varicoceles have been asserted as indications for surgical intervention. [3] In infertile men, subinguinal microsurgery has become an gold standard approach for spermatic vein ligation in infertile men with lower complication, and recurrence rates relative to other techniques, however the place of this approach in adolescent population is still debatable.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of testicular catch-up growth in adolescent microsurgical varicocelectomy

Bedir¹,

Keskin²,

Karabakan³

et al. 2017

Turkish Journal of Urology

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Objective: The incidence of varicocele is approximately 15% in adolecent men. Early treatment with varicocele is aimed to resolve testicular hypotrophy and ensure catch-up growth. The aim of this study was to evaluate ipsilateral catch-up growth rates relative to contralateral testicular growth in adolescents with varicocele undergoing microsurgical subinguinal varicocelectomy. Material and methods:Fifty adolescents with unilateral grade 2-3 varicoceles were included in the study. All patients underwent microsurgical subinguinal left varicocelectomies performed by the same experienced surgeon. All patients were evaluated clinically and using orchidometric measurements to define the grade of varicocele and testicular volume at presentation and follow-up. The number of internal and external spermatic veins, testicular arteries and lymphatic vessels preserved during the subinguinal microsurgical varicocelectomy were recorded. The mean follow-up period was 26 months (range 6-48 months).Results: At presentation, mean patient age was 12.9±2.1 years. Mean testicular preoperative volumes were 7.1±4.3 mL for the right and 5.4±3.4 mL for the left testis. There were significant differences between mean volumes of the right and left testis (p= 0.002). At the final postoperative follow-up visit, mean testicular volumes were 10.8±5.1 mL (range 3-25) for the right and 9.9±4.3 mL (range 2-20) for the left, and the difference between the right and left testicular volumes was insignificant (p= 0.47). In our series, catch-up growth was observed in 70% (35/50) of our patients. Conclusion:Adolescent varicocelectomy is associated with a higher percentage of patients showing testicular catch-up growth. In our study, similarly to the available literature the catch-up growth rate was found as 70% and observed to have positive effects of adolescent varicocelectomy on testicular growth.

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“…It has been also demonstrated that there is a clear increase in testicular size in adolescent subjects following surgical repair as well as a resumed growth of the testicle (Zampieri, 2008;Zampieri and Cervellione, 2008).…”

Section: Testicular Volume Diseases and Fertility Potentialmentioning

confidence: 99%

Testicular Catch-Up Growth

Zampieri

2011

Handbook of Growth and Growth Monitoring in Health and Disease

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Testicular growth depends on many different factors; through embryology, clinical data, and experimental studies we present the development of testes and the correlation with volume loss due to different diseases. We then show how the most common pediatric pathologies may affect testicular size and fertility potential. An undescended testis may affect spermatogenesis and the testicular volume, and this finding is strictly correlated with the timing of surgery. Varicocele still remains the most common surgical correctable andrological disease in adolescents and adults. Varicocele is associated with testicular growth arrest, impaired fertility, and low quality of spermatogenesis. Varicocelectomy, as suggested by international committees, should be performed at any age. Testicular catch-up growth after orchidopexy and varicocelectomy is common and still remains the most important outcome.

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Varicocele in Adolescents: A 6-Year Longitudinal and Followup Observational Study

Cited by 71 publications

References 15 publications

The hemodynamic approach to evaluating adolescent varicocele

The hemodynamic approach to evaluating adolescent varicocele

Evaluation of testicular catch-up growth in adolescent microsurgical varicocelectomy

Testicular Catch-Up Growth

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