Adolescent varicocelectomy--is the potential for catch-up growth related to age and/or Tanner stage?
OBJECTIVE
Adolescent varicocelectomy is associated with a 70% incidence of postoperative catch-up growth in boys with ipsilateral testicular hypotrophy. We determined whether preoperative patient age and Tanner stage were related to subsequent catch-up growth. In other words if patients are followed with a period of observation, will a window of opportunity be lost for achieving catch-up growth?


METHODS
We studied a total of 163 boys (mean age 15.1 years, range 10 to 24) with left or bilateral varicoceles who demonstrated 10% asymmetry or greater preoperatively, and had preoperative and postoperative testicular volume measurements available (using either ring orchidometer or ultrasound). Of these patients 59 also had preoperative Tanner stage recorded.


RESULTS
Of the patients with preoperative left hypotrophy 69% had achieved catch-up growth at last followup (mean followup 28 months). When treated as a continuous variable, or when divided into general prepubertal vs postpubertal groupings, age at surgery was not significantly associated with catch-up growth. Similarly, there was no significant difference in catch-up growth associated with grade of varicocele, duration of postoperative followup or presence of unilateral left vs bilateral varicocele. No association with Tanner stage was found, although the patient numbers were too small to draw any statistically significant conclusions.


CONCLUSIONS
The prevalence of testicular catch-up growth after varicocelectomy is high, even for patients in their early 20s. Among males 10 to 24 years old there is no specific age or Tanner stage that offers the best opportunity for catch-up growth.
Decastro
G Joel
GJ
Division of Pediatric Urology, Morgan Stanley Children's Hospital of New York-Presbyterian and Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Shabsigh
Ahmad
A
Poon
Stephen A
SA
Laor
Laurent
L
Glassberg
Kenneth I
KI
D000293:Adolescent; D000367:Age Factors; D002648:Child; D006801:Humans; D008297:Male; D013737:Testis / Q000254:growth & development*; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult