Testicular volume and semen parameters in patients aged 12 to 17 years with idiopathic varicocele.
OBJECTIVE
Varicocele is potentially a progressive condition that may affect fertility. The authors have encouraged sperm banking for their postpubertal patients with varicocele and aim to evaluate the sperm parameters in this cohort of patients.


METHODS
With institutional ethical approval, sperm variables (volume, concentration, and forward motility) of patients with postpubertal varicocele who opted for sperm banking were prospectively recorded. The following parameters were also acquired: (a) ultrasound measurement of testicular volume, (b) clinical grade, and (c) venous Doppler. Patients were divided into 2 groups: symmetrical testis (group A) and asymmetrical testis (group B). Testicular asymmetry was defined as greater than 20% difference in testicular volume compared with contralateral testis. Sperm parameters were compared between groups A and B using Mann-Whitney U test and P < .05.


RESULTS
Fifteen patients were included: 10 in group A and 5 in group B. Median semen concentration in group B was significantly lower than group A (3 vs 26 million/mL; P = .04). One hundred percent of group B failed World Health Organisation adult criteria for normal spermiograms compared with 50% of group A.


CONCLUSIONS
Sperm concentration and quality was lower in patients with asymmetrical testis. Testicular dysfunction may be present before the onset of testicular hypotrophy. When testicular hypotrophy is present, testicular dysfunction is very likely.
Department of Paediatric Urology, Royal Manchester Children's Hospital, M13 9WL Manchester, United Kingdom. dkeene@nhs.net
David J B
DJ
Keene
Yasmin
Y
Sajad
George
G
Rakoczy
Raimondo M
RM
Cervellione
D000293:Adolescent; D002648:Child; D018450:Disease Progression; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D012661:Semen / Q000166:cytology*; D013074:Sperm Banks; D013076:Sperm Count; D013081:Sperm Motility; D013737:Testis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D014646:Varicocele / Q000150:complications / Q000473:pathology*