title: Transient asynchronous testicular growth in adolescent males with a varicocele.
abstract: OBJECTIVE
  We assessed the testicular growth of adolescent males followed nonsurgically for the presence of left varicocele.
  
  
  METHODS
  We retrospectively reviewed the charts of adolescent males with a diagnosis of unilateral left varicocele and ultrasound testis volume measurements seen during a 10-year period. A total of 161 boys underwent at least 2 testicular ultrasounds as part of the evaluation for left varicocele. Patients were excluded from study for a history of inguinal/scrotal pathology or endocrinopathy that could affect testicular size. Sonographic testicular volume was calculated using the Lambert volume (length x width x height x 0.71). The resulting volumes were compared to previously published criteria for surgical repair (15%, 20% and 2 cc size differentials).
  
  
  RESULTS
  Of the 71 boys with 3 followup ultrasounds 38 (54%) initially had a 15% or greater volume differential. After nonsurgical followup with ultrasounds for 2 years 60 boys (85%) had testicular volume differentials in the normal range (less than 15%). Of the patients 71% were spared potential surgery by size criteria and 50% were spared surgery by the same 15% volume differential criteria.
  
  
  CONCLUSIONS
  Adolescent males with unilateral left varicocele often demonstrate asynchronous testicular growth that usually equalizes in time. Therefore, sonographic testicular size measurement at a single point during adolescence is insufficient to determine the need for varicocelectomy. When contemplating varicocelectomy we recommend at least 2, and preferably 3, testicular volume measurements 1 year apart to establish accurately decreased left testicular volume compared to a normal right testis.
authors.affiliation: Division of Urology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Kolon
authors.forename: Michele R
authors.initials: MR
authors.lastname: Clement
authors.forename: Lisa
authors.initials: L
authors.lastname: Cartwright
authors.forename: Richard
authors.initials: R
authors.lastname: Bellah
authors.forename: Michael C
authors.initials: MC
authors.lastname: Carr
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Canning
authors.forename: Howard M
authors.initials: HM
authors.lastname: Snyder
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013737:Testis / Q000000981:diagnostic imaging / Q000254:growth & development*; D014463:Ultrasonography; D014646:Varicocele / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy