HORMONAL PARAMETERS AND TESTICULAR VOLUME IN CHILDREN AND ADOLESCENTSWITH UNILATERAL VARICOCELE - PREOPERATIVE AND POSTOPERATIVE FINDINGS

Preoperative and postoperative testicular volume, serum testosterone, follicle-stimulating hormone and luteinizing hormone were determined i n 25 patients 8 to 19 years old (mean age 13.2 +/- 1.63) with grades 2 and 3 unilateral varicocele. Testicular growth arrest was considered significant when volume loss was greater than 2 ml. in the ipsilateral testis compared to the contralateral side. Baseline serum testosteron e, follicle-stimulating hormone and luteinizing hormone as well as pos t-gonadotropin releasing hormone stimulation were determined preoperat ively and at 4 to 6 months postoperatively. Data are presented as mean plus or minus standard deviation. Results showed an increase in serum testosterone in Tanner's stages 1 (p <0.028) and 2 to 3 (p <0.008). N o differences were recorded in basal luteinizing hormone and follicle- stimulating hormone, as well as maximal follicle-stimulating hormone l evels before and after surgery. A decrease of maximal luteinizing horm one response to gonadotropin releasing hormone test was noted postoper atively in pubertal stages 4 to 5, when compared to preoperative value s. Postoperative ipsilateral testicular volume increased in all Tanner stages (p <0.045, p <0.008 and p <0.012, respectively). Our observati ons suggest that varicocele may be initially responsible for interstit ial dysfunction with preservation of germinal function and unilateral testicular growth arrest, however reversible, after pubertal surgical correction. This study supports previous reports suggesting that varic ocelectomy in children who show anatomic and functional changes is adv isable.