ASSESSMENT OF ADOLESCENT VARICOCELE

Varicocele is the most important male factor responsible for decreased fertility potential in married couples. From March through June 1994, 2,470 school boys aged 10-20 years were examined to establish the inc idence of consecutive grades of varicocele and to develop a protocol f or diagnosis and treatment of adolescents with varicocele. Grade 1 var icocele was found in 18%, grade 2 in 12%, and grade 3 in 5% of the pop ulation examined. An original protocol of ultrasonographic (US) examin ation (previously verified by angioscintigraphy) was introduced to ass ess boys with clinically diagnosed varicocele. The volume of each test is, testicular volume decrease (TVD), pampiniform vein diameter (PVD), and basal (BBF) and maximum blood flow (MBF) velocities were measured in 625 boys. In 74 cases a semen analysis was performed. The statisti cal analysis revealed that the presence of venous reflux and PVD corre lated with the grade of varicocele. Decreases in testicular volume wer e highly dependent on the grade of varicocele, PVD, and BBF and MBF ve locities. Analysis of the relationship between spermatic (boys over 17 years) and US findings revealed that the quality of spermatogenesis c an be predicted by US examination in adolescents with varicocele. The authors recommend multiparametric US examination as a reliable, object ive, and repeatable technique for establishing criteria for operative treatment in boys under 18 years of age with varicocele as well as for postoperative evaluation.