Testicular catch-up growth after varicocele correction in adolescents.
We evaluated retrospectively the outcome of artery-sparing (AS) versus non-artery-sparing (NAS) laparoscopic varicocelectomy and measured any reversal of testicular growth. Twenty patients (13 left and 7 bilateral varicoceles) were evaluated after surgery. A total of 27 varicocelectomies (20 AS and 7 NAS) were performed. The indication for surgery was smaller testicular size on the affected side in all patients and discomfort/pain in 3. The mean age was 12.9 years (range 8-15 years) at surgery. The testicular volumes were determined clinically and by color Doppler sonography (US). The follow-up time was 6-48 months after surgery. There were 4 recurrences out of 27 varicocelectomies (15%), of which 1 has been reoperated. Testicular volumes were equal in both groups after surgery, indicating catch-up growth except in the cases with minor recurrences (2 AS and 2 NAS varicocelectomies). In 12 testes, dilated veins in the pampiniform plexus were revealed by US. No severe intraoperative complications occurred. Three patients had a hydrocele after surgery (11%). These data show that there is testicular catch-up growth after varicocelectomy, but some questions remain unanswered: (1) should the remaining dilated veins detected by Doppler US be tackled; and (2) is an AS operation worthwhile?
Lund
L
L
Division of Paediatric Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
Tang
Y C
YC
Roebuck
D
D
Lee
K H
KH
Liu
K
K
Yeung
C K
CK
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D013737:Testis / Q000098:blood supply / Q000254:growth & development*; D013997:Time Factors; D014646:Varicocele / Q000503:physiopathology / Q000601:surgery*