Painful varicocele in pediatric age: is there a correlation between pain, testicular damage and hormonal values to justify surgery?
OBJECTIVE
Pain is one of the indications to treat varicocele at any age. The purpose of this study is to find a possible correlation between pain and objective testicular damage through the analysis of hormonal values.


METHODS
Between 1990 and 2001, varicocelectomy was performed on 44 adolescents with painful varicocele using two different techniques. Thirty-eight patients were eligible for the study. Pre- and post-operative hormonal values were analyzed retrospectively to find a possible correlation between pain and testicular damage or discomfort. The patients had to fill out a simple questionnaire about their type of pain following a two-grade rating scale. After treatment, relief of pain or persistence of symptoms were recorded.


RESULTS
Six months after surgery 26 patients showed complete relief of pain. There was not a statistically significant correlation between grade of varicocele, type of surgery and relief of symptoms. Clinically there was not a statistically significant correlation between pain and hormonal values.


CONCLUSIONS
Management of painful varicocele in pediatric patients should be studied through randomized trials comparing conservative and surgical treatments. While waiting for objective data supporting surgery, clinical evidence justifies varicocelectomy which, on the other hand, is not supported by objective clinical data (i.e., hormonal values).
Zampieri
Nicola
N
Pediatric Surgical Unit, Department of Surgical Sciences, Policlinico G.B.Rossi, University of Verona, Piazzale L.A.Scuro n.1, 37134, Verona, Italy. dr.zampieri@libero.it
Ottolenghi
Alberto
A
Camoglio
Francesco Saverio
FS
D000293:Adolescent; D016009:Chi-Square Distribution; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications / Q000601:surgery*
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