TESTICULAR GROWTH AFTER SUCCESSFUL VARICOCELE CORRECTION IN ADOLESCENTS - COMPARISON OF ARTERY SPARING TECHNIQUES WITH THE PALOMO PROCEDURE

Testicular growth after varicocele surgery was evaluated in 116 boys 9 to 20 years old. A total of 88 boys was available for followup testic ular examination 3 to 60 months after successful varicocele repair (me an 25). Left testicular volume loss of 2 cc or greater was present pre operatively in 72 of the 88 patients. The Palomo procedure was perform ed in 36 cases and repair using artery sparing techniques was done in 36. Mean relative left testicular volume increased 18% in the artery s paring group and 21% in the Palomo group. The increase in relative tes ticular volume compared to preoperative volumes was statistically sign ificant in both groups (p <0.05). There was no significant difference in testicular growth between the groups and no postoperative testicula r atrophy was observed. A comparison group of 8 boys with uncorrected varicoceles demonstrated a mean relative volume increase of 3% (mean f ollowup 22 months). The increase in testis volume in successfully corr ected cases was statistically different (p <0.05) from that of uncorre cted cases. We conclude that reversal of varix induced testicular grow th failure occurs only after successful surgical correction. The Palom o procedure resulted in equivalent testicular growth compared to the a rtery sparing techniques with fewer complications and no testicular at rophy despite intentional ligation of the testicular artery. Based on our data, we believe that the Palomo procedure should be the procedure of choice for adolescent varicocele correction.