Purpose: There is evidence that varicocele damage, as reflected by los
s of testicular mass, is most striking in the pubertal age group. We a
ttempted to evaluate the long-term effect of early varicocele treatmen
t on testicular growth and sperm count and, thus, determine its prophy
lactic value. Materials and Methods: We compared testicular mass and s
perm count in 32 men (mean age 28 years) who underwent surgery for var
icocele at 11 to 15 years old (mean age 13) to those in 26 untreated,
age matched men (mean age 30 years) with varicocele and 27 male contro
ls (mean age 25 years). Mean followup in the treated group was 14.5 ye
ars (range 12 to 20). Testicular volumes were measured by ultrasonogra
phy. Results: There was no significant difference between left and rig
ht testicular volumes in the treated or control group, in contrast to
the untreated group, in which the left testicles were significantly sm
aller. Comparison of testicular mass showed a striking similarity betw
een the treated and control groups, while there was a significant diff
erence when the untreated group was compared to the control and operat
ed groups. Total sperm counts were significantly less in the untreated
than the treated and control groups. Conclusions: These data support
the notion that testicular hypotrophy related to varicocele may be rev
ersed by early intervention and they further strengthen the indication
for varicocelectomy in children.