REPAIR VERSUS OBSERVATION IN ADOLESCENT VARICOCELE - A PROSPECTIVE-STUDY

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.