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

Reyes, Thomas de Los; Locke, Jennifer A.; Afshar, Kourosh

doi:10.5489/cuaj.4340

Cited by 15 publications

(12 citation statements)

References 55 publications

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“…The presence of varicocele has been postulated to affect testosterone production and, in turn, the hypothalamic-pituitary-gonadal axis. However, in terms of endocrine evaluation, the utility of obtaining a baseline hormonal evaluation for identifying adolescents at risk for infertility has not yet been demonstrated, and the significance of testosterone changes pre- and post-intervention remains unclear [ 27 ]. Multiple recent studies support a relationship between varicocele and the development of hypogonadism and androgen deficiency, potentially providing an impetus for early varicocele repair [ 28 29 ].…”

Section: Discussionmentioning

confidence: 99%

Current Issues in Adolescent Varicocele: Pediatric Urological Perspectives

Chung

2018

World J Mens Health

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While varicocele is the most common cause of surgically correctable infertility in adult males, with repair resulting in improved semen parameters in 60% to 80% of men and a higher likelihood of conception in up to 60% of men, the rationale for varicocele repair in the pediatric population is less clear. Additionally, prepubertal varicoceles are much less common and their management is controversial. Adolescents with a varicocele are often in the midst of a progressive disease process. Despite the high prevalence of varicocele and its association with progressive disease processes, the indications for adolescent varicocele repair and the effects thereof on paternity have been persistently challenging to study. This review will briefly present some of the current issues regarding adolescent varicocele from a pediatric urological point of view, including the evaluation of adolescent varicocele, the optimal surgical indications, the optimal choice of surgical intervention to be performed, and outcomes.

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Section: Discussionmentioning

confidence: 99%

Current Issues in Adolescent Varicocele: Pediatric Urological Perspectives

Chung

2018

World J Mens Health

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“…Nonetheless, endocrine evaluation in adolescents carries practical considerations. Immaturity of the hypothalamic-pituitary-gonadal axis in the different stages of development would demand different standards for evaluation 40 . Fideleff et al 41 performed a prospective study with 93 adolescents and found no difference in hormonal parameters of FSH, LH, Testosterone and GnRH from varicocele individuals and controls, even after correction of Tanner stage.…”

Section: Seminal Analysis and Hormonal Evaluationmentioning

confidence: 99%

Varicocele in the adolescent population: challenges in management

Cardoso

Tiseo

Cocuzza

2018

Rev. Med. (São Paulo)

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Management of varicoceles in adolescents remain one of the most interesting and debatable topics. Although the crescent awareness of varicocele-induced testicular impairment has motivated several studies, some of the controversies in adult varicocele, regarding pathophysiology, treatment and fertility issues can also be transposed the adolescent population. Furthermore, adolescents represent a heterogenic group with challenges in diagnosis, clinical parameters, and limited predictors. Physical and pubertal development reflects in difficulties for standard management. The purpose of this article is to review available data from literature regarding the presentation, epidemiology and pathogenesis of varicocele in children and adolescents. We also address major limitations and challenges of clinical evaluation and provide current evidence regarding the dilemma of varicocele treatment in this particular subset of patients. Interventions options and outcomes are also discussed. The current review is based on an electronic search using Pubmed/MEDLINE databases and references of the identified articles performed between March and May of 2018.

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“…This disease can cause an increase in reactive oxygen species and cause oxidative stress leading to sperm dysfunction (Heidari et al, 2016). Among men undergoing infertility investigation, approximately 30%-40% have varicocele (De Los Reyes, Locke, & Afshar, 2017;Punab et al, 2017;Sofimajidpour, Ghaderi, & Ganji, 2016). Among men undergoing infertility investigation, approximately 30%-40% have varicocele (De Los Reyes, Locke, & Afshar, 2017;Punab et al, 2017;Sofimajidpour, Ghaderi, & Ganji, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of varicocele is 4.4%-22.6% in the general population; however, it is present in 35%-44% of cases of primary infertility and in more than 45-81% of men with secondary infertility (Heidari et al, 2016;Jensen et al, 2017). Among men undergoing infertility investigation, approximately 30%-40% have varicocele (De Los Reyes, Locke, & Afshar, 2017;Punab et al, 2017;Sofimajidpour, Ghaderi, & Ganji, 2016).…”

Section: Introductionmentioning

confidence: 99%

Y chromosome microdeletions and varicocele as aetiological factors of male infertility: A cross-sectional study

et al. 2017

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The pathogenic mechanisms by which varicocele disrupt spermatogenesis are not clearly understood. Over 30% of male infertility cases resulting from spermatogenic problems are associated with genetic abnormalities, and Y chromosome microdeletions are the second most frequent genetic cause. Here, we aimed to evaluate the frequency of Y chromosome microdeletion in infertile men with varicocele. A cross-sectional study comprising 51 infertile men with varicocele presenting spermatogenesis failures was performed. Y chromosome microdeletion research was made using polymerase chain reaction. Of the 51 men with infertility and varicocele, 35.3% (18/51) had nonobstructive azoospermia and 64.7% had severe oligozoospermia. Y chromosome microdeletion was found in two cases (3.9%): one patient had nonobstructive azoospermia and complete microdeletion of the AZFb and AZFc regions, and another patient had severe oligozoospermia and complete microdeletion of the AZFc region. Although in recent years, a genetic aetiology related to Y chromosome microdeletions has become a major cause of infertility in males with spermatogenesis failures, in this study, the varicocele was the clinical cause of seminal abnormalities that could lead to infertility, suggesting that both varicocele and Y chromosome microdeletion aetiologies can present, alone or combined, as factors of male infertility.

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

Cited by 15 publications

References 55 publications

Current Issues in Adolescent Varicocele: Pediatric Urological Perspectives

Current Issues in Adolescent Varicocele: Pediatric Urological Perspectives

Varicocele in the adolescent population: challenges in management

Y chromosome microdeletions and varicocele as aetiological factors of male infertility: A cross-sectional study

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