Da. Paduch et J. Niedzielski, REPAIR VERSUS OBSERVATION IN ADOLESCENT VARICOCELE - A PROSPECTIVE-STUDY, The Journal of urology, 158(3), 1997, pp. 1128-1132
Purpose: We designed a randomized prospective study of male adolescent
s with moderate and severe varicoceles to determine whether prophylact
ic varicocele repair is beneficial. Materials and Methods: We evaluate
d 2,100 boys (10 to 20 years old) for genitourinary abnormalities. Fro
m this population 2 groups of adolescents 15 to 19 years old with grad
e 2 or 3 varicoceles were created, including 88 who underwent varicoce
le repair and 36 controls. Testicular volume and pampiniform vein diam
eter were measured, and Doppler ultrasound was performed. Results: Aft
er 12 months volume of the involved left testis increased to almost no
rmal in treated boys (mean atrophy index 12.7% at surgery and 3% 12 mo
nths later), In controls the corresponding atrophy indexes were 10 and
9%, respectively. The relative increase in left testicular volume was
26% in the surgery group and 11% in controls. In the surgery group me
an pampiniform vein diameter decreased from 2.8 preoperatively to 2 mm
. postoperatively but there was no change in controls. Conclusions: Va
ricocele repair in adolescents with moderate and severe varicocele rev
ersed testicular growth arrest and resulted in catch-up growth within
12 month of surgery.